Pill no longer a no for lupus patients

TRENTON, N.J. — Upending conventional medical wisdom, two studies found that birth-control pills do not worsen lupus and appear to be safe for the tens of thousands of women with the immune disorder.

"For 30 years, we were all wrong," said Dr. Michelle Petri, lead researcher on one of the studies and director of the Lupus Center at Johns Hopkins University School of Medicine.

The studies, involving hundreds of women in the United States and Mexico, found that oral contraceptives do not increase flare-ups in women with lupus, a sometimes-fatal disease that mostly strikes women of childbearing age.

For decades, believing that the estrogen in the pills could trigger flare-ups, doctors had "a complete prohibition against oral contraceptives" for lupus patients, Petri said.

The two studies were reported in today's New England Journal of Medicine.

In Petri's study at 14 U.S. sites, 91 women took estrogen-progestin combination pills, while 92 women in a comparison group got a placebo; all also used barrier contraceptives. Over a year, seven women in each group had a severe lupus flare-up; each group had 1.4 mild or moderate flare-ups a year.

In the second study, conducted at the National Institute of Medical Science and Nutrition in Mexico City, 162 women were split into three groups. One got estrogen-progestin pills, the second got progestin-only pills, and the third got an intrauterine device, or IUD, without hormones. Each group had similar results on flare-ups, symptoms and side effects. "Both studies clearly show that most women with lupus can take oral contraceptives safely," Petri said.