PMID- 27023359
OWN - NLM
STAT- MEDLINE
DCOM- 20160815
LR  - 20161126
IS  - 2326-5205 (Electronic)
IS  - 2326-5191 (Linking)
VI  - 68
IP  - 4
DP  - 2016 Apr
TI  - Brief Report: Menopause and Primary Ovarian Insufficiency in Women Treated for 
      Antineutrophil Cytoplasmic Antibody-Associated Vasculitides.
PG  - 986-92
LID - 10.1002/art.39522 [doi]
AB  - OBJECTIVE: One of the side effects of cyclophosphamide is earlier menopause and 
      primary ovarian insufficiency. This study was undertaken to investigate the onset 
      of menopause and the incidence of primary ovarian insufficiency in women with 
      antineutrophil cytoplasmic antibody-associated vasculitis (AAV), especially after 
      treatment with orally administered cyclophosphamide. METHODS: We retrospectively 
      studied the onset of menopause and the influence of cyclophosphamide in women 
      diagnosed as having AAV in our center between 1970 and 2012. RESULTS: Ninety-four 
      premenopausal women diagnosed as having AAV were included. Sixty-seven patients 
      received cyclophosphamide, and 27 received other, mostly immunosuppressive, 
      medication. Forty-six cyclophosphamide-treated women developed menopause, 22 of 
      whom were considered to have primary ovarian insufficiency. None of the patients 
      who were not treated with cyclophosphamide developed primary ovarian 
      insufficiency. There was a significant association between a cumulative 
      cyclophosphamide dose of >16.6 gm, versus a cumulative dose of <16.6 gm, and 
      menopause (chi(2)  = 8.72, P = 0.003; odds ratio [OR] 2.60 [95% confidence interval 
      1.38-4.90]). In addition, there was a significant association between a 
      cumulative cyclophosphamide dose of <16.6 gm, versus no cyclophosphamide 
      exposure, and menopause (chi(2)  = 16.37, P < 0.001; OR 7.32 [95% confidence 
      interval 2.79-19.20]). Both women who received cyclophosphamide and those who did 
      not experienced involuntary childlessness. CONCLUSION: Earlier menopause and 
      primary ovarian insufficiency frequently develop after oral cyclophosphamide 
      therapy in premenopausal women with AAV. Involuntary childlessness is common 
      after the development of primary ovarian insufficiency, but it also occurs in 
      women not treated with cyclophosphamide. These findings emphasize the importance 
      of the use of drugs that are not toxic to gonadal function in women of 
      childbearing age.
CI  - (c) 2016, American College of Rheumatology.
FAU - Tuin, Janneke
AU  - Tuin J
AD  - University of Groningen and University Medical Center Groningen, Groningen, The 
      Netherlands.
FAU - Sanders, Jan-Stephan F
AU  - Sanders JS
AD  - University of Groningen and University Medical Center Groningen, Groningen, The 
      Netherlands.
FAU - van Beek, Andre P
AU  - van Beek AP
AD  - University of Groningen and University Medical Center Groningen, Groningen, The 
      Netherlands.
FAU - Hoek, Annemieke
AU  - Hoek A
AD  - University of Groningen and University Medical Center Groningen, Groningen, The 
      Netherlands.
FAU - Stegeman, Coen A
AU  - Stegeman CA
AD  - University of Groningen and University Medical Center Groningen, Groningen, The 
      Netherlands.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arthritis Rheumatol
JT  - Arthritis & rheumatology (Hoboken, N.J.)
JID - 101623795
RN  - 0 (Immunosuppressive Agents)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - HU9DX48N0T (Mycophenolic Acid)
RN  - MRK240IY2L (Azathioprine)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adult
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug therapy
MH  - Azathioprine/therapeutic use
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Cyclophosphamide/*therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Incidence
MH  - Maintenance Chemotherapy
MH  - *Menopause
MH  - Methotrexate/therapeutic use
MH  - Middle Aged
MH  - Mycophenolic Acid/analogs & derivatives/therapeutic use
MH  - Prednisolone
MH  - Primary Ovarian Insufficiency/*epidemiology
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Rituximab/therapeutic use
MH  - Young Adult
EDAT- 2016/03/31 06:00
MHDA- 2016/08/16 06:00
CRDT- 2016/03/30 06:00
PHST- 2015/02/08 00:00 [received]
PHST- 2015/11/12 00:00 [accepted]
PHST- 2016/03/30 06:00 [entrez]
PHST- 2016/03/31 06:00 [pubmed]
PHST- 2016/08/16 06:00 [medline]
AID - 10.1002/art.39522 [doi]
PST - ppublish
SO  - Arthritis Rheumatol. 2016 Apr;68(4):986-92. doi: 10.1002/art.39522.