ArticleArthritis care & research2022
Predictors of Osteonecrosis in Systemic Lupus Erythematosus: A Prospective Cohort Study.
Article in Arthritis care & research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Meta-analysis of factors for osteonecrosis in systemic lupus erythematosus: integration of comprehensive literatures and multicenter databases.Frontiers in immunology · 2026Pooled it
- Reply.Arthritis care & research · 2026Article
- Corticosteroid-associated osteonecrosis in paediatric compared with adult patients: are they the same disease?Bone & joint open · 2026Article
- Autologous collagen-induced chondrogenesis with high tibial osteotomy for large collapsed steroid-induced osteonecrosis in a patient with systemic lupus erythematosus: a case report and literature review.BMC musculoskeletal disorders · 2025Review
- Sex- and gender-related differences in systemic lupus erythematosus: a scoping review.Rheumatology international · 2025Article
- 30-day readmission after total hip and knee arthroplasty in patients with systemic lupus erythematosus: A US nationwide study.Journal of orthopaedics · 2025Article
- Exploring the association between systemic lupus erythematosus and osteonecrosis by Mendelian randomization analysis.Scientific reports · 2025Article
- Systemic lupus erythematosus: updated insights on the pathogenesis, diagnosis, prevention and therapeutics.Signal transduction and targeted therapy · 2025Review
- Incidence and Factors Associated With Recurrent Pericarditis in Lupus.JAMA network open · 2025Article
- Avascular necrosis in pediatric rheumatic diseases: an Italian retrospective multicentre study.Italian journal of pediatrics · 2025Article
- Asymptomatic multifocal avascular necrosis, a commonly overlooked finding in patients with systemic lupus erythematosus.BMC rheumatology · 2024Article
- Joint surgery rates in lupus: a long-term cohort study.Lupus science & medicine · 2024Article
- The association of an elevated Th/Ts ratio and lupus anticoagulant with symptomatic osteonecrosis in systemic lupus erythematosus patients.Frontiers in immunology · 2024Article
- Risk factors and prediction model for osteonecrosis of the femoral head in female systemic lupus erythematosus.Frontiers in immunology · 2024Article
- Effects of astragaloside IV on glucocorticoid-induced avascular necrosis of the femoral head via regulating Akt-related pathways.Cell proliferation · 2023Article
- Risk factors for avascular necrosis in patients with systemic lupus erythematosus: a multi-center cohort study of Chinese SLE Treatment and Research Group (CSTAR) Registry XXII.Arthritis research & therapy · 2023Article
- Identification of key genes and pathways associated with gender difference in osteonecrosis of the femoral head based on bioinformatics analysis.Journal of musculoskeletal & neuronal interactions · 2023Article
- Bone Involvement in Systemic Lupus Erythematosus.International journal of molecular sciences · 2022Review
- Risk factors of avascular necrosis in Takayasu arteritis: a cross sectional study.Rheumatology international · 2022Observational
- Clinical Study on Systemic Lupus Erythematosus Complicated with Knee Bone Infarction.International journal of clinical practice · 2022Article
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Abstract
objectiveWe aimed at determining the predictors of osteonecrosis (ON) in a longitudinal lupus cohort.
methodsData were reviewed from the initiation of the cohort in 1987 until October 2019. In total, 2,428 patients were included in the analysis based on 224,295 person-months of follow-up. We used pooled logistic regression to assess the relationship between risk factors and rates of ON events. After identifying a set of variables related to ON incidence, we fit a final multivariable model to identify the most important risk factors for incident ON.
resultsIn 18,691 person-years of follow-up after cohort entry, 122 incident ON events were observed (rate = 6.5/1,000 person-years). In the multivariable analysis, African American patients were at twice the risk for ON compared to White patients. Male patients and smokers had an increased risk for ON of ~80% and 50% compared to female patients and nonsmokers, respectively. For every 10-year increase in the age at diagnosis, there was a 20% reduced risk for ON. Patients diagnosed after the 1990s had a 50% reduced risk of ON compared to those diagnosed before the 1990s. A highest daily dosage of prednisone of 40 mg or higher, even when administered for a month or less, significantly increased the risk of ON. Use of pulse methylprednisolone or intramuscular triamcinolone was not associated with an increased risk of ON.
conclusionAfrican American patients with systemic lupus erythematosus are at double the risk of experiencing ON compared to White patients. Oral prednisone at 20-39 mg for more than 1 month, or 40 mg daily for even 1 month, at any point in the disease course, remained the most important glucocorticoid predictor of ON.
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