ArticleThe Korean journal of internal medicine2022
Epidemiology and risk factors associated with avascular necrosis in patients with autoimmune diseases: a nationwide study.
Article in The Korean journal of internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 30 citations in OpenAlex.
- [Research progress on the application of telitacicept in rheumatism and autoimmune diseases].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2026Review
- Atraumatic elbow avascular necrosis in the adult is rare, multifocal, and associated with systemic corticosteroid use.JSES international · 2025Article
- Avascular necrosis in pediatric rheumatic diseases: an Italian retrospective multicentre study.Italian journal of pediatrics · 2025Article
- Shoulder pain: to image or not to image?Frontiers in rehabilitation sciences · 2025Article
- Chronic Sarcoidosis: Diagnostic Difficulties and Search for New Criteria of Inflammatory Activity (A Case Report and Literature Review).Journal of clinical medicine · 2024Review
- Trends in avascular necrosis and related arthroplasties in hospitalized patients with systemic lupus erythematosus and rheumatoid arthritis.Seminars in arthritis and rheumatism · 2024Article
- The Role of Osteogenic Effect and Vascular Function in Bone Health in Hypertensive Rats: A Study of Anti-hypertensive and Hemorheologic Drugs.Calcified tissue international · 2024Article
- Risk factors and prediction model for osteonecrosis of the femoral head in female systemic lupus erythematosus.Frontiers in immunology · 2024Article
- Rare diagnosis of coexistent antiphospholipid syndrome and systemic lupus erythematosus in a male patient with successful management: a case report.Annals of medicine and surgery (2012) · 2023Article
- The Utility of Ultrasound in Evaluating Joint Pain in Systemic Lupus Erythematosus: Looking beyond Fibromyalgia.Journal of personalized medicine · 2023Article
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4 authors at 1 institution in 1 country.
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Abstract
BACKGROUND/
aimsAvascular necrosis (AVN) is a clinical condition characterized by the death of bone components due to interruption in the blood supply. This study aimed to investigate the epidemiology and determine the risk factors for AVN in patients with autoimmune diseases.
methodsWe conducted a population-based retrospective cohort analysis using claims data from the Taiwan National Health Insurance Research Database. A total of 49,636 patients with autoimmune diseases between January 1, 2005 and December 31, 2013 were included. Cox regression analysis was used to identify associated risk factors for the development of AVN.
resultsA total of 490/49,636 patients (1.0%) developed symptomatic AVN. The systemic lupus erythematosus patients had a higher risk of AVN compared to other autoimmune diseases. AVN was positively correlated with male sex (p < 0.001), alcoholism (p < 0.001), mean daily prednisolone dosage 7.51 to 30 mg (p < 0.001) and > 30 mg (p < 0.001), and total cumulative prednisolone dose 0 g to 5 g (p = 0.002). However, AVN was inversely correlated with cumulative duration of hydroxychloroquine exposure > 0.6 years (p < 0.001).
conclusionMale sex, systemic lupus erythematosus, alcoholism, mean daily corticosteroid > 7.5 mg and a total cumulative dose of corticosteroid 0 to 5 g were independently associated with the development of AVN in autoimmune patients. While hydroxychloroquine use > 0.6 years conferred significant protection against the development of AVN. Clinicians should regularly assess patients with risk factors to enable the early diagnosis of AVN.
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