Randomized Study of Oral Contraceptives or Hormone Replacement Therapy in Women With Systemic Lupus Erythematosus

NCT ID: NCT00006133

Last Updated: 2005-06-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

970 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-06-30

Brief Summary

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OBJECTIVES: I. Determine the effect of oral contraceptives containing low-dose synthetic estrogens and progestins on disease activity in premenopausal women with inactive, stable, or moderate systemic lupus erythematosus (SLE).

II. Determine the effect of hormone replacement therapy with conjugated estrogens and progestins on disease activity in postmenopausal women with inactive, stable, or moderate SLE.

Detailed Description

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PROTOCOL OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to age/menopausal status (35 and under/premenopausal vs 50 and over/postmenopausal). Both strata are randomized to one of two treatment arms.

Stratum 1 (Premenopausal/Oral contraceptives): Patients receive either oral ethinyl estradiol and norethindrone or placebo daily for 28 days beginning on the Sunday following the first day of the menstrual cycle.

Stratum 2 (Postmenopausal/Hormone replacement therapy): Patients receive either oral estradiol and medroxyprogesterone or placebo on days 1-12 monthly.

Treatment continues in both arms of both strata for a total of 13 courses in the absence of a severe disease flare-up or other complication that would preclude further study participation.

All patients are followed at 1 year.

Conditions

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Systemic Lupus Erythematosus

Keywords

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arthritis & connective tissue diseases immunologic disorders and infectious disorders rare disease systemic lupus erythematosus

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

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estradiol

Intervention Type DRUG

ethinyl estradiol

Intervention Type DRUG

medroxyprogesterone

Intervention Type DRUG

norethindrone

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

PROTOCOL ENTRY CRITERIA:

--Disease Characteristics--

Established systemic lupus erythematosus meeting American College of Rheumatology criteria

Inactive disease Systemic Lupus Erythematosus Activity Index (SLEDAI) score no greater than 4

No increase in score of more than 2 from baseline over the past 3 months

Receiving the equivalent of 5 mg or less of prednisone per day OR Stable/active disease SLEDAI score 5-12

No increase in score of more than 2 from baseline over the past 3 months

Prednisone dose up to 0.5 mg/kg/day for control of underlying disease allowed if stable dose for at least 3 weeks

No concurrent severe disease activity as defined by any of the following:

* Acute renal disease (i.e., rising creatinine levels, cellular sediment, or increasing proteinuria)
* Involvement of 3 or more organ systems requiring more than the equivalent of 0.5 mg/kg/day of prednisone
* Necessity of immediate hospitalization for symptom control

No presence of a high titer IgG, IgM, or IgA antiphospholipid antibodies (aPL) GPL and MPL no more than 40 APL no more than 50

No features of primary antiphospholipid antibody syndrome

--Prior/Concurrent Therapy--

Biologic therapy: Not specified

Chemotherapy: Not specified

Endocrine therapy: See Disease Characteristics

Radiotherapy: Not specified

Surgery: Prior hysterectomy allowed

--Patient Characteristics--

Age: 35 and under for oral contraceptive stratum (premenopausal) 50 and over for hormone replacement therapy stratum (postmenopausal)

Menopausal status:

* Premenopausal for oral contraceptive stratum
* Postmenopausal for hormone replacement therapy stratum
* Follicle-stimulating hormone greater than 40 mIU/mL OR Amenorrhea for 6 months

Performance status: See Disease Characteristics

Hematopoietic: Not specified

Hepatic:

* No hepatic dysfunction
* No tumors of the liver

Renal: See Disease Characteristics

Cardiovascular:

* No uncontrolled high blood pressure requiring frequent change in medication
* Concurrent hypertension controlled with stable medication allowed
* No history of spontaneous superficial or deep venous thrombosis or arterial thrombosis
* No prior myocardial infarction
* Oral contraceptive stratum: No angina No diastolic blood pressure greater than 90 mm Hg or systolic blood pressure greater than 140 mm Hg on 3 separate determinations
* Hormone replacement therapy stratum: No diastolic blood pressure greater than 95 mm Hg or systolic blood pressure greater than 145 mm Hg on 3 separate determinations

Pulmonary: No history of pulmonary embolus

Other:

* Not pregnant
* Oral contraceptive stratum: Negative pregnancy test Fertile patients must use effective barrier contraception
* No prior gynecologic malignancy or breast malignancy
* No undiagnosed vaginal bleeding
* No diabetes (present prior to use of glucocorticoids) requiring oral hypoglycemic medications or insulin
* No congenital hyperlipidemia
* No complicated migraines (i.e., associated with neurological sequelae)
Minimum Eligible Age

0 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

National Center for Research Resources (NCRR)

NIH

Sponsor Role lead

Principal Investigators

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Graciela S. Alarcon

Role: STUDY_CHAIR

University of Alabama at Birmingham

Locations

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University of Alabama Comprehensive Cancer Center

Birmingham, Alabama, United States

Site Status

University of California Los Angeles

Los Angeles, California, United States

Site Status

University of California-San Francisco

San Francisco, California, United States

Site Status

Pritzker School of Medicine

Chicago, Illinois, United States

Site Status

Louisiana State University School of Medicine

Shreveport, Louisiana, United States

Site Status

Johns Hopkins University School of Medicine

Baltimore, Maryland, United States

Site Status

University of Michigan Health Systems

Ann Arbor, Michigan, United States

Site Status

Hospital for Joint Diseases

New York, New York, United States

Site Status

Saint Luke's-Roosevelt Hospital Center

New York, New York, United States

Site Status

Hospital for Special Surgery

New York, New York, United States

Site Status

Rheumatology Associates of Long Island

Port Jefferson Station, New York, United States

Site Status

Montefiore Medical Center

The Bronx, New York, United States

Site Status

University of North Carolina

Chapel Hill, North Carolina, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

University of Texas- Houston Medical School

Houston, Texas, United States

Site Status

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

Other Identifiers

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UAB-SELENA

Identifier Type: -

Identifier Source: secondary_id

199/15327

Identifier Type: -

Identifier Source: org_study_id