Hermine Brunner, MD.

Hermine Brunner, MD

Young women with severe lupus need higher doses than expected of a medication that can protect their ovaries during chemotherapy, according to research led by a scientist at Cincinnati Children’s.

Physicians often prescribe cyclophosphamide to patients with childhood-onset systemic lupus erythematosus (cSLE) once the disease becomes severe enough to threaten the kidneys or other organs. However, chemotherapy can lead to infertility among some women if steps are not taken to protect their ovaries.

The drug triptorelin is used to protect ovaries among older adult women of reproductive age. Hermine Brunner, MD, Director of the Division of Rheumatology at Cincinnati Children’s, led a team of researchers who worked to establish an ideal dosage of triptorelin for adolescents and young adults less than 21 years old. Their work was published online in February 2015 in Arthritis & Rheumatology.

Triptorelin dosed at 120 mg per kilo of body weight led to sustained ovarian suppression, which prevents the ovaries from making estrogen, in 90 percent of study participants. On average, it required 22 days to achieve suppression, the researchers found. This dosage level is higher than that used for older adults, but the medication was well tolerated.