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Postmenopausal Estrogen Therapy and the Risk for Developing Systemic Lupus Erythematosus

Jorge Sanchez-Guerrero, MD, MSc; Matthew H. Liang, MD, MPH; Elizabeth W. Karlson, MD; David J. Hunter, MBBS; and Graham A. Colditz, MBBS, DrPH
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From Harvard Medical School, Brigham and Women's Hospital, and Harvard School of Public Health, Boston, Massachusetts. Requests for Reprints: Graham A. Colditz, MBBS, Nurses' Health Study, Channing Laboratory, 180 Longwood Avenue, Boston, MA 02115. Acknowledgments: The authors thank the nurses who participated in this study; Karen Corsano, Barbara Egan, and Mark Shneyder for their expert assistance; and F.E. Speizer, the principal investigator of the Nurses' Health Study, for providing access to the database and suggestions. Grant Support: By NIH grants CA 40396 and AR36308. Dr. Sanchez-Guerrero is supported by a Research Fellowship Award, Fogarty International Center, NIH 5F05 TW04573-02.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1995;122(6):430-433. doi:10.7326/0003-4819-122-6-199503150-00005
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Objective: To examine the relation between postmenopausal hormone use and development of systemic lupus erythematosus.

Design: Prospective cohort study.

Setting: Nurses' Health Study.

Patients: 69 435 women aged 30 to 55 years in 1976 who reported that they had completed menopause and did not have systemic lupus erythematosus or any connective tissue disease were followed every 2 years from 1976 to 1990. These women were classified as never-or ever-(current and past) users of postmenopausal hormones.

Measurements: Incidence rates of systemic lupus erythematosus and classification criteria from the American College of Rheumatology that were confirmed by chart review.

Results: With never-users of postmenopausal hormones as the reference group, age-adjusted relative risks for systemic lupus erythematosus (n = 45 women) were 2.1 (95% CI, 1.1 to 4.0) for ever-users, 2.5 (CI, 1.2 to 5.0) for current users, and 1.8 (CI, 0.8 to 4.1) for past users. A proportional increase in the risk for systemic lupus erythematosus was observed that was related to the duration of use of postmenopausal hormones (test for trend, P = 0.011).

Conclusions: Postmenopausal hormone therapy is associated with an increased risk for developing systemic lupus erythematosus.

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