Clara Di Mario1, Luca Petricca2, Maria Rita Gigante2, Angelina Barini3,4, Antonella Barini4, Valentina Varriano1, Annamaria Paglionico1, Paola Cattani5,6, Gianfranco Ferraccioli1,2, Barbara Tolusso2, Elisa Gremese7,8. 1. Institute of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy. 2. Division of Rheumatology, Fondazione Policlinico Universitario "A. Gemelli"-I.R.C.C.S., Rome, Italy. 3. Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore, Rome, Italy. 4. Institute of Biochemistry and Clinical Biochemistry, Fondazione Policlinico Universitario "A. Gemelli"-I.R.C.C.S., Rome, Italy. 5. Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy. 6. Institute of Microbiology, Fondazione Policlinico Universitario "A. Gemelli"-I.R.C.C.S., Rome, Italy. 7. Institute of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy. elisa.gremese@unicatt.it. 8. Division of Rheumatology, Fondazione Policlinico Universitario "A. Gemelli"-I.R.C.C.S., Rome, Italy. elisa.gremese@unicatt.it.
Abstract
PURPOSE: Systemic lupus erythematosus (SLE) mainly affects childbearing age women and pharmacological treatments may negatively influence the ovarian reserve. Anti-Müllerian hormone (AMH) could be a good biomarker for ovarian reserve. METHODS: AMH serum levels were assessed in 86 consecutive SLE female patients with regular menstrual cycle compared with 44 aged matched healthy controls. Clinical and demographic characteristics, disease duration, pattern of organ involvement, and previous and current therapies were recorded. RESULTS: AMH levels were comparable between patients and controls (4.2 ± 3.1 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.21). According to disease severity, AMH levels were lower in SLE patients with major organ involvement than in controls (3.8 ± 2.7 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.08); no difference was found between SLE patients with mild organ involvement (4.5 ± 3.4 ng/ml) and controls (p = 0.43). Grouping patients based on the pharmacological treatments, AMH serum levels did not differ among SLE patients treated with antimalarials only (4.7 ± 3.3 ng/ml), conventional disease-modifying antirheumatic drugs (cDMARDs) only (4.8 ± 3.2 ng/ml), cDMARDs and antimalarials (3.9 ± 2.9 ng/ml) or cyclophosphamide (CYC) only (4.9 ± 3.9 ng/ml), compared to controls, but patients sequentially treated with cDMARDs and CYC, had significantly lower AMH serum levels than controls (p = 0.01). CONCLUSIONS: SLE patients showed comparable AMH levels than controls, however, a reduction of the ovarian reserve was associated with sequentially therapy with CYC and cDMARDs and with the disease severity. AMH could be a sensitive and specific biomarker of ovarian reserve in SLE and it could be useful for therapeutic strategy and family planning.
PURPOSE:Systemic lupus erythematosus (SLE) mainly affects childbearing age women and pharmacological treatments may negatively influence the ovarian reserve. Anti-Müllerian hormone (AMH) could be a good biomarker for ovarian reserve. METHODS:AMH serum levels were assessed in 86 consecutive SLE female patients with regular menstrual cycle compared with 44 aged matched healthy controls. Clinical and demographic characteristics, disease duration, pattern of organ involvement, and previous and current therapies were recorded. RESULTS:AMH levels were comparable between patients and controls (4.2 ± 3.1 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.21). According to disease severity, AMH levels were lower in SLEpatients with major organ involvement than in controls (3.8 ± 2.7 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.08); no difference was found between SLEpatients with mild organ involvement (4.5 ± 3.4 ng/ml) and controls (p = 0.43). Grouping patients based on the pharmacological treatments, AMH serum levels did not differ among SLEpatients treated with antimalarials only (4.7 ± 3.3 ng/ml), conventional disease-modifying antirheumatic drugs (cDMARDs) only (4.8 ± 3.2 ng/ml), cDMARDs and antimalarials (3.9 ± 2.9 ng/ml) or cyclophosphamide (CYC) only (4.9 ± 3.9 ng/ml), compared to controls, but patients sequentially treated with cDMARDs and CYC, had significantly lower AMH serum levels than controls (p = 0.01). CONCLUSIONS:SLEpatients showed comparable AMH levels than controls, however, a reduction of the ovarian reserve was associated with sequentially therapy with CYC and cDMARDs and with the disease severity. AMH could be a sensitive and specific biomarker of ovarian reserve in SLE and it could be useful for therapeutic strategy and family planning.
Authors: Didier Dewailly; Claus Yding Andersen; Adam Balen; Frank Broekmans; Nafi Dilaver; Renato Fanchin; Georg Griesinger; Tom W Kelsey; Antonio La Marca; Cornelius Lambalk; Helen Mason; Scott M Nelson; Jenny A Visser; W Hamish Wallace; Richard A Anderson Journal: Hum Reprod Update Date: 2014-01-14 Impact factor: 15.610