ArticleTherapeutic advances in musculoskeletal disease2026
Three-drug combination therapy to prevent glucocorticoid-associated osteonecrosis in patients with systemic lupus erythematosus: a proof-of-concept study.
Article in Therapeutic advances in musculoskeletal disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Systemic lupus erythematosus (SLE) is a major underlying disease of glucocorticoid-associated osteonecrosis of the femoral head (ONFH). Despite its clinical significance, no prophylactic treatment has been established to prevent ONFH in patients receiving systemic glucocorticoid therapy. Objectives: To investigate the efficacy and safety of a three-drug combination therapy consisting of clopidogrel sulfate, pitavastatin calcium hydrate, and tocopherol acetate, administered concurrently with initial glucocorticoid therapy to prevent ONFH in patients with SLE. Design: A multicenter, single-arm, interventional clinical trial conducted as an advanced medical treatment approved by the Ministry of Health, Labor and Welfare of Japan. Methods: This study was conducted at 12 sites in Japan between August 2014 and March 2024. Patients with SLE who required initial glucocorticoid therapy (⩾0.5 mg/kg/day of prednisolone) received the three study drugs concurrently with glucocorticoids for 90 days. Magnetic resonance imaging of both hip joints was performed 180 days after initiation of glucocorticoid therapy to determine ONFH occurrence. The primary endpoint was ONFH incidence, and safety and potential risk factors were also evaluated using logistic regression analysis. Results: Of the 50 enrolled patients, 43 completed the 90-day regimen. ONFH was identified in 8 of 43 patients (18.6%), which was below the threshold incidence of 25% based on the historical control, suggesting a potential signal of reduced incidence ( Conclusion: The findings demonstrate the feasibility and acceptable safety of this three-drug combination therapy. Although the results should be regarded as preliminary and hypothesis-generating, they suggest a potential signal that warrants further investigation in adequately powered randomized controlled trials. Trial registration: Clinical trial for the control of osteonecrosis of the femoral head secondary to the initial corticosteroid treatment in patients with systemic lupus erythematosus (UMIN000008230; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000009636).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.