ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2014
Elevated risk of clinical fractures and associated risk factors in patients with systemic lupus erythematosus versus matched controls: a population-based study in the United Kingdom.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Prevalence and Risk Factors of Reduced Bone Mineral Density in Systemic Lupus Erythematosus Patients: A Meta-Analysis.BioMed research international · 2019Pooled it
- Fracture risk and bone mineral density levels in patients with systemic lupus erythematosus: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Pooled it
- Fracture risk tools performance and potential use in systemic lupus erythematosus.Lupus science & medicine · 2026Observational
- Factors influencing therapeutic efficacy of denosumab against osteoporosis in systemic lupus erythematosus.Lupus science & medicine · 2025Article
- Changes in the incidence and prevalence of systemic lupus erythematosus between 1990 and 2020: an observational study using the Clinical Practice Research Datalink (CPRD).Lupus science & medicine · 2024Observational
- Adverse Outcomes, Healthcare Resource Utilization, and Costs Associated with Systemic Corticosteroid use Among Adults with Systemic Lupus Erythematosus in the UK.Rheumatology and therapy · 2023Article
- Osteoimmunology: The effect of autoimmunity on fracture healing and skeletal analysis.Forensic science international. Synergy · 2023Review
- Estimation of fracture risk by the FRAX tool in patients with systemic lupus erythematosus: a 10-year longitudinal validation study.Therapeutic advances in musculoskeletal disease · 2022Article
- The Categorization of Pain in Systemic Lupus Erythematosus.Rheumatic diseases clinics of North America · 2021Review
- Article
- Health-care utilization and costs in adults with systemic lupus erythematosus in the United Kingdom: a real-world observational retrospective cohort analysis.Rheumatology advances in practice · 2021Article
- Disease severity, flares and treatment patterns in adults with systemic lupus erythematosus in the UK: a real-world observational retrospective cohort analysis.Rheumatology advances in practice · 2021Article
- Incidence and risk factors for osteoporotic fractures in patients with systemic lupus erythematosus versus matched controls.The Korean journal of internal medicine · 2021Article
- Prevalence of osteoporosis in patients with systemic lupus erythematosus: A multicenter comparative study of the World Health Organization and fracture risk assessment tool criteria.Osteoporosis and sarcopenia · 2020Article
- Effects of Systemic Glucocorticoid Use on Fracture Risk: A Population-Based Study.Endocrinology and metabolism (Seoul, Korea) · 2020Article
- Evaluation of risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis.Journal of orthopaedic surgery and research · 2020Article
- Management of glucocorticoid-related osteoporotic vertebral fracture.Osteoporosis and sarcopenia · 2020Review
- Comparative Fracture Risks Among United States Medicaid Enrollees With and Those Without Systemic Lupus Erythematosus.Arthritis & rheumatology (Hoboken, N.J.) · 2019Article
- Bone Mineral Loss and Fracture in Sarcoidosis: A Systematic Review and Meta-Analysis.Archives of rheumatology · 2019Article
- Glucocorticoid-induced osteoporosis: 2019 concise clinical review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Review
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
Abstract
unlabelledThe incidence of clinical fractures and the associated factors were assessed in patients with systemic lupus erythematosus (SLE) versus matched controls. We found an increased fracture risk in SLE patients compared to controls. Glucocorticoid use, longer disease duration, neuropsychiatric disease complications and previous osteoporotic fractures were identified as associated factors.
introductionThe aims of this study were to estimate the risk of clinical fractures in patients with SLE versus matched controls and to evaluate the risk factors associated with clinical fractures in SLE.
methodsThis is a population-based cohort study using the Clinical Practice Research Datalink (from 1987-2012). Each SLE patient (n = 4,343) was matched with up to six controls (n = 21,780) by age and sex. Clinical fracture type was stratified according to the WHO definitions into osteoporotic and non-osteoporotic fracture. Cox proportional hazards calculated relative rates (RR) of clinical fracture and time interaction terms to evaluate the timing patterns of fracture. Clinical fracture rates in SLE patients, stratified by age, gender, type of fracture, disease duration and therapy variables, were compared with those rates in controls.
resultsFollow-up durations were 6.4 years in SLE patients and 6.6 years in controls. SLE patients had a 1.2-fold increased clinical fracture risk compared to controls (adjusted RR = 1.22, 95% CI = 1.05-1.42), and the risk further increased with a longer disease duration. Glucocorticoid (GC) use in the previous 6 months raised the risk of clinical fracture (adjusted RR = 1.27, 95% CI = 1.02-1.58). Cerebrovascular events, seizures and previous osteoporotic fractures were identified as predictors of clinical fractures.
conclusionsWe found an increased risk of clinical fracture in SLE patients compared to controls. GC use in the previous 6 months and longer disease duration are associated with the increased fracture risk in SLE. Patients with neuropsychiatric organ damage or previous osteoporotic fractures are also at increased risk of the occurrence of clinical fractures.
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