Sex hormones and sex hormone-targeting therapies in systemic sclerosis: A systematic literature review

Seminars in Arthritis and Rheumatism
Jacopo CiaffiJeska K de Vries-Bouwstra

Abstract

The pathophysiology of systemic sclerosis (SSc) is complex and elusive, however, considering the strong female preponderance and different clinical characteristics between men and women, a contribution of sex hormones has been proposed. We undertook this systematic literature review to investigate: (1) the role played by male and female sex hormones in the pathogenesis of SSc; (2) how sex hormone levels change in SSc patients and how hormonal variations modify the progression of SSc; (3) the effect of therapies targeting sex hormones on the disease course. A literature search was performed in Pubmed, Embase, Web of Science, and Cochrane library databases. Given the heterogeneity in study design, different quality assessment tools were applied where appropriate. We retrieved 300 articles and 30 were included in the review. The available evidence points to a fibrogenic, but also a vasodilatory, role of estrogens in SSc. With the limitation of small sample sizes, women with SSc tend to have lower levels of androgens and non-significantly higher levels of estradiol compared to healthy controls, while in men we found increased levels of estradiol and discordant results for androgens. After menopause the skin score seems to decrease ...Continue Reading

Citations

Oct 4, 2020·Nature Reviews. Rheumatology·Maurizio Cutolo, Rainer H Straub
Jan 23, 2021·Current Opinion in Rheumatology·Leonardo Martin Calderon, Janet E Pope
Feb 10, 2021·Journal of Photochemistry and Photobiology. B, Biology·Weiwei LiuTakashi Ikejima
Sep 7, 2021·Clinical Reviews in Allergy & Immunology·Marie Elise TruchetetCarlo Chizzolini

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