Abstract
Autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis (scleroderma) preferentially affect women, and are characterized by systemic inflammation leading to target organ dysfunction. The public health burden of autoimmune diseases, which collectively represent a leading cause of morbidity and mortality among women throughout adulthood, is substantial. While some features of these diseases have been observed to improve over the menopausal transition, such as disease flare rate in SLE and skin softening and thinning in scleroderma, others, such as swollen and tender joints and radiographically confirmed damage in RA may worsen. The general trends, however, are not consistent or conclusive for all disease-related manifestations. Of great importance is the recognition that comorbid diseases, including osteoporosis and accelerated cardiovascular disease, contribute excess morbidity and mortality that becomes increasingly apparent as women with autoimmune diseases undergo the menopausal transition.
Highlights
Autoimmune diseases are characterized by systemic inflammation, in which a dysregulated immune system causes damage or dysfunction to target organs
While rheumatic autoimmune diseases can occur across the lifespan, the typical presentation occurs in mid- or late- adulthood [3]
Effective targeted therapies for rheumatoid arthritis (RA) have rapidly expanded over the last decade, leading to improved outcomes, but treatment options for systemic lupus erythematosus (SLE) and scleroderma remain largely based on traditional immunosuppressive and anti-inflammatory agents which are associated with a range of toxicities [4]
Summary
Autoimmune diseases are characterized by systemic inflammation, in which a dysregulated immune system causes damage or dysfunction to target organs. Rheumatic autoimmune diseases include conditions such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and systemic sclerosis (scleroderma), in which the connective tissues (cartilage, joint synovium, skin) are most frequently targeted. While rheumatic autoimmune diseases can occur across the lifespan, the typical presentation occurs in mid- or late- adulthood [3]. These diseases are considerably more common in women than in men, with approximately 90 % of prevalent cases being female for SLE and scleroderma, and approximately 75 % for RA [3]. Data from the last 15 years have demonstrated that when autoimmune diseases are considered as a group, they rank among the 10 leading causes of death among women under age 75 years [8, 9]
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