Fernández M et al. (2007) Systemic lupus erythematosus in a multiethnic US cohort (LUMINA II): relationship between vascular events and the use of hormone replacement therapy in postmenopausal women. J Clin Rheumatol 13: 261–265

Hormone replacement therapy (HRT) is still indicated for the treatment of some postmenopausal women. Whether postmenopausal women with systemic lupus erythematosus (SLE) can safely use it is uncertain, because HRT might increase the occurrence of arterial and venous thrombotic events. Fernández et al. analyzed data from the LUMINA study—a multiethnic, longitudinal study of outcome in SLE patients—to assess the influence of HRT on the occurrence of thrombotic events in postmenopausal women.

The LUMINA cohort includes patients aged ≥16 years with SLE disease duration ≤5 years. Ten of the 82 postmenopausal women in this cohort (mean ± SD age 53.7 ± 7.7 years) were excluded from analysis (9 were positive for antiphospholipid antibodies and 1 had suffered an arterial thrombotic event before HRT exposure). Of the remaining 72 patients, 40 were never-users and 32 were HRT users; data on dose and exact duration of exposure to HRT were not available, but overall in this group exposure duration was 60% of total SLE disease duration.

HRT use was not associated with an increased occurrence of thrombotic events. Indeed, there was a trend towards decreased occurrence of arterial events in HRT users in the univariate analyses, but this effect became nonsignificant after adjustment for confounders.

The findings indicate that HRT might be safe for postmenopausal women with SLE, as long as these patients are not at high-risk for thromboembolic events.