Osteonecrosis of the hip in Korean patients with systemic lupus erythematosus: risk factors and clinical outcome

J, Lee; Sk, Kwok; Sm, Jung; Hk, Min; Hc, Nam; Seo, J-H; Ju, Jianhua; Ks, Park; Park, Sang Hoon; Hy, Kim

doi:10.1177/0961203313512880

Cited by 27 publications

(35 citation statements)

References 21 publications

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“…Some studies of patients with non‐multifocal ON with SLE have reported that ON tends to occur in young patients, usually in the first 5 years after SLE onset . In the cases identified in our retrospective review and our literature review, the onset age of multifocal ON and the interval between the onset of rheumatic disease and multifocal ON were similar to those of non‐multifocal ON.…”

Section: Discussionsupporting

confidence: 64%

Clinical characteristics of multifocal osteonecrosis in Korean patients with rheumatic disease

et al. 2017

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Section: Discussionsupporting

confidence: 64%

Clinical characteristics of multifocal osteonecrosis in Korean patients with rheumatic disease

et al. 2017

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“…Immunological conditions such as systemic lupus erythematosus, 11 12 Sjogren’s syndrome, 8 11 dermatomyositis, 8 mixed connective tissue disease, 8 rheumatoid arthritis, 8 adult-onset Still disease 11 or scleroderma 11 have previously been associated with increased risk of ON. These associations may be mediated by use of corticosteroids 8 or other immunosuppressive drugs, 33 or may be related to the specific disease activity itself. 34 …”

Section: Discussionmentioning

confidence: 99%

Association of common comorbidities with osteonecrosis: a nationwide population-based case–control study in Denmark

Dima

Pedersen

et al. 2018

BMJ Open

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ObjectiveTo examine recent time trends in the incidence of osteonecrosis (ON) in Denmark and to investigate different common comorbidities association with ON in a population-based setting.MethodsUsing Danish medical databases, we included all patients with a first-time hospital diagnosis of ON during 1995–2012. Each ON case was matched with 10 randomly selected population control subjects from general population. For all participants, we obtained a complete hospital history of comorbidities included in the CharlsonComorbidity Index 5 years preceding the inclusion date.Results4107 ON cases and 41 063 controls were included. The incidence of ON increased from 3.9 in 1995 to 5.5 in 2012 per 100 000 inhabitants. Solid cancer was the most common comorbidity, associated with an adjusted OR (aOR) for ON of 2.0 (95% CI 1.7 to 2.2). For advanced metastatic cancer, leukaemia and lymphoma, aORs of ON were 3.4 (95% CI 2.5 to 4.5), 4.3 (95% CI 2.7 to 7.0) and 5.8 (95% CI 4.3 to 7.8), respectively. Among other chronic conditions, aORs were 3.5 (95% CI 3.0 to 4.1) for connective tissue diseases and 2.3 (95% CI 2.0 to 2.7) for chronic pulmonary diseases. aORs were also increased at 2.8 (95% CI 1.9 to 4.1) and 4.5 (95% CI 2.5 to 8.2) for mild and moderate-to-severe liver disease, respectively, and 4.2 (95% CI 3.4 to 5.2) for renal disease.ConclusionThis large population-based study provides evidence for an increasing ON incidence in the general population and documents an association between several common comorbid conditions and risk of ON.

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“…Risk factors related to laboratory results. Overall, studies that investigated the association between aCL and ON did not find a significant association (Figure 4) 3,17,20 26,53,59 , and mycophenolate mofetil 22,26,30,38 were not associated with a higher risk of ON.…”

Section: Rheumatologymentioning

confidence: 95%

“…In fact, some authors found that immunosuppressive therapy is a risk factor for ON 17,22,30,32,42,57 . Conversely, these agents could be surrogates for disease activity, which could be a risk for ON.…”

Section: Rheumatologymentioning

confidence: 99%

Monitoring of Osteonecrosis in Systemic Lupus Erythematosus: A Systematic Review and Metaanalysis

et al. 2018

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Objective.Nontraumatic osteonecrosis (ON) is a well-recognized complication causing disability and affecting quality of life in patients with systemic lupus erythematosus (SLE). The aim of this study was to identify the risk factors for ON, and to identify the minimal investigation(s) needed to optimally monitor the risk of ON in patients with SLE.Methods.A systematic review was conducted using MEDLINE and EMBASE. These databases were searched up to January 2016 using the Medical Subject Heading (MeSH) terms “Osteonecrosis,” “Systemic lupus erythematosus,” and synonymous text words. Randomized controlled trials, case control, cohort, and cross-sectional studies were included. Risk factors for ON in patients with SLE were compiled. The quality of each study was assessed using the Newcastle-Ottawa scale for nonrandomized studies. The quality of evidence of each risk factor was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation method.Results.Of the 545 references yielded, 50 met inclusion criteria. Corticosteroid (CS) use may be strongly associated with ON in patients with SLE. Other clinical variables were moderately associated, including hypertension, serositis, renal disease, vasculitis, arthritis, and central nervous system disease. However, the evidence was low to very low in quality.Conclusion.Based on the best evidence available, CS use may be strongly associated with ON in patients with SLE. Results of this review were considered in the development of recommendations for the diagnosis and monitoring of patients with SLE in Canada and will guide clinicians in their assessment of these patients.

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Osteonecrosis of the hip in Korean patients with systemic lupus erythematosus: risk factors and clinical outcome

Abstract: Advanced ARCO stage at the onset of ON is an independent risk factor for THR in SLE patients with ON. In ARCO stage I-III ON, patients with NPSLE and those receiving > 0.9 g prednisolone during the first six months after the ON diagnosis are likely to require THR.

Cited by 27 publications

References 21 publications

Clinical characteristics of multifocal osteonecrosis in Korean patients with rheumatic disease

Clinical characteristics of multifocal osteonecrosis in Korean patients with rheumatic disease

Association of common comorbidities with osteonecrosis: a nationwide population-based case–control study in Denmark

Monitoring of Osteonecrosis in Systemic Lupus Erythematosus: A Systematic Review and Metaanalysis

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