Evidence map›Paper›PMID 41483218›Full record

ArticleJournal of bone and mineral metabolism2026

Bone fragility and atypical femoral fractures in SLE: role of disease activity, infection, and treatment.

Hiroe Sato, Naoki Kondo, Tomoya Watarai, Eriko Hasegawa, Ayako Wakamatsu, Yukiko Nozawa, Daisuke Kobayashi, Takeshi Kuroda, Suguru Yamamoto

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Article in Journal of bone and mineral metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Hiroe SatoDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan. hiroes@med.niigata-u.ac.jp.ORCID http://orcid.org/0000-0002-3952-7163
Naoki KondoDivision of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
Tomoya WataraiDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
Eriko HasegawaDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
Ayako WakamatsuDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
Yukiko NozawaDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
Daisuke KobayashiDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
Takeshi KurodaDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.
Suguru YamamotoDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-Ku, Niigata City, 951-8510, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTo determine the incidence and risk factors of fragility fractures and atypical femoral fracture (AFF)-related events in patients with systemic lupus erythematosus (SLE) receiving long-term glucocorticoid (GC) therapy. MATERIALS AND

methodsA retrospective analysis was conducted of 170 SLE patients followed from 2016 to 2023. Data on GC use, bisphosphonate (BP) therapy, bone-related events, and clinical characteristics were collected. Risk factors for fragility fractures and AFF-related events, including localized periosteal thickening (LPT), were analyzed using multivariate logistic regression.

resultsAlthough the median daily dose of prednisolone decreased over time, 82.9% of patients still met the criteria for pharmacologic intervention for GC-induced osteoporosis in 2023, and most continued to receive > 5 mg/day of GC. The median duration of BP therapy was 10.4 years, with 69 patients maintaining BP treatment throughout the observation period (median, 12.5 years). Fragility fractures and AFF-related events occurred in 7.6% and 5.8% of patients, respectively. Fragility fractures were independently associated with SLE flares and infection-related hospitalizations, whereas AFF-related events were significantly associated with prolonged BP use.

conclusionDespite a gradual reduction in GC dosage, many patients with longstanding SLE remain at elevated risk for fractures. The comparable frequencies of fragility fractures and AFF-related events highlight the clinical relevance of both complications. The prevention of SLE flares and infections may contribute to lowering the risk of fragility fractures. In addition, careful monitoring for AFF/LPT is warranted in patients receiving long-term BP and GC therapy.

Indexed as

Femoral FracturesInfectionsLupus Erythematosus, SystemicAdultDiphosphonatesFemaleGlucocorticoidsHumansMaleMiddle AgedOsteoporosisRetrospective StudiesRisk FactorsDiphosphonatesGlucocorticoidsAtypical femoral fractureBisphosphonateFemoral localized periosteal thickeningFragility fractureGlucocorticoid

Identifiers

PMID41483218

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.