Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients

Influence of the disease severity and therapy on the ovarian reserve

Clara Di Mario, Luca Petricca, Maria Rita Gigante, Angelina Barini, Antonella Barini, Valentina Varriano, Annamaria Paglionico, Paola Cattani, Gianfranco Ferraccioli, Barbara Tolusso, Elisa Gremese

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalEndocrine
DOIs
Publication statusE-pub ahead of print - Oct 15 2018

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Systemic Lupus Erythematosus
Hormones
Antirheumatic Agents
Serum
Cyclophosphamide
Antimalarials
Therapeutics
Biomarkers
Pharmacology
Ovarian Reserve
Family Planning Services
Menstrual Cycle
Demography

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Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients : Influence of the disease severity and therapy on the ovarian reserve. / Di Mario, Clara; Petricca, Luca; Gigante, Maria Rita; Barini, Angelina; Barini, Antonella; Varriano, Valentina; Paglionico, Annamaria; Cattani, Paola; Ferraccioli, Gianfranco; Tolusso, Barbara; Gremese, Elisa.

In: Endocrine, 15.10.2018.

Research output: Contribution to journalArticle

Di Mario, Clara ; Petricca, Luca ; Gigante, Maria Rita ; Barini, Angelina ; Barini, Antonella ; Varriano, Valentina ; Paglionico, Annamaria ; Cattani, Paola ; Ferraccioli, Gianfranco ; Tolusso, Barbara ; Gremese, Elisa. / Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients : Influence of the disease severity and therapy on the ovarian reserve. In: Endocrine. 2018.
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title = "Anti-M{\"u}llerian hormone serum levels in systemic lupus erythematosus patients: Influence of the disease severity and therapy on the ovarian reserve",
abstract = "PURPOSE: Systemic lupus erythematosus (SLE) mainly affects childbearing age women and pharmacological treatments may negatively influence the ovarian reserve. Anti-M{\"u}llerian 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.",
author = "{Di Mario}, Clara and Luca Petricca and Gigante, {Maria Rita} and Angelina Barini and Antonella Barini and Valentina Varriano and Annamaria Paglionico and Paola Cattani and Gianfranco Ferraccioli and Barbara Tolusso and Elisa Gremese",
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TY - JOUR

T1 - Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients

T2 - Influence of the disease severity and therapy on the ovarian reserve

AU - Di Mario, Clara

AU - Petricca, Luca

AU - Gigante, Maria Rita

AU - Barini, Angelina

AU - Barini, Antonella

AU - Varriano, Valentina

AU - Paglionico, Annamaria

AU - Cattani, Paola

AU - Ferraccioli, Gianfranco

AU - Tolusso, Barbara

AU - Gremese, Elisa

PY - 2018/10/15

Y1 - 2018/10/15

N2 - 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.

AB - 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.

U2 - 10.1007/s12020-018-1783-1

DO - 10.1007/s12020-018-1783-1

M3 - Article

JO - Endocrine

JF - Endocrine

SN - 1355-008X

ER -