ArticleArthritis research & therapy2023
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.
Article in Arthritis research & therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 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
- Population characteristics, glucocorticoid dosage, and risk factors for osteonecrosis of the femoral head in systemic lupus erythematosus: a Systematic Review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Efficacy and safety of belimumab in lupus nephritis: a real-world retrospective observational study stratified by treatment phase and age.Clinical rheumatology · 2026Observational
- Impact of high disease activity on damage accrual and disease outcomes in childhood-onset systemic lupus erythematosus.Frontiers in pediatrics · 2026Article
- Avascular necrosis in pediatric rheumatic diseases: an Italian retrospective multicentre study.Italian journal of pediatrics · 2025Article
- Enhanced risk prediction of femoral head osteonecrosis in the elderly: a comparative study of random forest and logistic regression models.Frontiers in medicine · 2025Article
- Risk factors and prediction model for osteonecrosis of the femoral head in female systemic lupus erythematosus.Frontiers in immunology · 2024Article
- The association of an elevated Th/Ts ratio and lupus anticoagulant with symptomatic osteonecrosis in systemic lupus erythematosus patients.Frontiers in immunology · 2024Article
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19 authors at 12 institutions in 1 country.
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Abstract
backgroundAvascular necrosis is a common organ damage in SLE patients, which can influence patients' life quality. Conflicting results exist in risk factors of AVN in SLE patients. The aim of this study was to illustrate risk factors predicting the occurrence of avascular necrosis (AVN), also known as osteonecrosis, in systemic lupus erythematosus (SLE) patients in Chinese SLE Treatment and Research Group (CSTAR), a multi-center cohort of Chinese SLE patients.
methodsSLE patients in CSTAR without existing AVN at registration were included. At least two follow-ups and an observation period of no less than 2 years for AVN event were required. Univariate and multivariate Cox regression analyses were used to evaluate risk factors for AVN in SLE patients. Coefficient B was transformed to risk score for the development of a risk stratification model.
resultsOne hundred six (2.59%) of 4091 SLE patients were diagnosed AVN during follow-ups of no less than 2 years. Multi-variate Cox regression analysis suggested that SLE onset age ≤ 30 (HR 1.616, p 0.023), arthritis (HR 1.642, p 0.018), existing organ damage (SDI ≥ 1) at registration (HR 2.610, p < 0.001), positive anti-RNP (HR 1.709, p 0.006), and high glucocorticoid maximum daily dose at registration (HR 1.747, p 0.02) were independent risk factors. A risk stratification system was developed according to the risk factors, and patients were divided into high risk (3-6) and low risk (0-2). The AUC of 0.692 indicated moderate discrimination. The calibration curve in internal validation was drawn.
conclusionPatients with SLE onset age ≤ 30, arthritis, existing organ damage (SDI ≥ 1) at registration, positive anti-RNP, and high glucocorticoid maximum daily dose at registration are at high risk for AVN and require attention.
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