Factors Associated With Osteonecrosis in Thai Lupus Patients

Uea-Areewongsa, Parichat; Chaiamnuay, Sumapa; Narongroeknawin, Pongthorn; Asavatanabodee, Paijit

doi:10.1097/rhu.0b013e3181ba3423

Cited by 24 publications

(30 citation statements)

References 24 publications

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“…Risk factors related to laboratory results. Overall, studies that investigated the association between aCL and ON did not find a significant association (Figure 4) 3,17,20 26,53,59 , and mycophenolate mofetil 22,26,30,38 were not associated with a higher risk of ON.…”

Section: Rheumatologymentioning

confidence: 95%

Monitoring of Osteonecrosis in Systemic Lupus Erythematosus: A Systematic Review and Metaanalysis

et al. 2018

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Objective.Nontraumatic osteonecrosis (ON) is a well-recognized complication causing disability and affecting quality of life in patients with systemic lupus erythematosus (SLE). The aim of this study was to identify the risk factors for ON, and to identify the minimal investigation(s) needed to optimally monitor the risk of ON in patients with SLE.Methods.A systematic review was conducted using MEDLINE and EMBASE. These databases were searched up to January 2016 using the Medical Subject Heading (MeSH) terms “Osteonecrosis,” “Systemic lupus erythematosus,” and synonymous text words. Randomized controlled trials, case control, cohort, and cross-sectional studies were included. Risk factors for ON in patients with SLE were compiled. The quality of each study was assessed using the Newcastle-Ottawa scale for nonrandomized studies. The quality of evidence of each risk factor was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation method.Results.Of the 545 references yielded, 50 met inclusion criteria. Corticosteroid (CS) use may be strongly associated with ON in patients with SLE. Other clinical variables were moderately associated, including hypertension, serositis, renal disease, vasculitis, arthritis, and central nervous system disease. However, the evidence was low to very low in quality.Conclusion.Based on the best evidence available, CS use may be strongly associated with ON in patients with SLE. Results of this review were considered in the development of recommendations for the diagnosis and monitoring of patients with SLE in Canada and will guide clinicians in their assessment of these patients.

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Section: Rheumatologymentioning

confidence: 95%

Monitoring of Osteonecrosis in Systemic Lupus Erythematosus: A Systematic Review and Metaanalysis

et al. 2018

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“…Inconclusive results were yielded by analyzing the association of osteonecrosis with some typical features of SLE like vasculitis [4, 8], Raynaud's phenomenon [4, 6, 9], antiphospholipid antibody positivity [5, 6, 8, 10, 40, 44], and with administration of antimalarial drugs [4, 11]. Many authors reported a higher frequency of Cushingoid body habitus among SLE patients who developed osteonecrosis [8, 45, 46].…”

Section: Factors Associated With the Development Of Osteonecrosis mentioning

confidence: 99%

“…The presence of arthritis [4], renal involvement [11], and the prevalence of anti-DNA and of various anti-ENA antibodies [5] could not be identified as risk factors for osteonecrosis. No differences in lipid profile were observed between SLE patients with and without osteonecrosis [11, 43, 44].…”

Section: Factors Associated With the Development Of Osteonecrosis mentioning

confidence: 99%

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Osteonecrosis in Systemic Lupus Erythematosus: An Early, Frequent, and Not Always Symptomatic Complication

Caramaschi

Biasi

Forno

et al. 2012

Autoimmune Diseases

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Osteonecrosis may complicate the course of systemic lupus erythematosus and may contemporaneously affect multiple joints. The major risk factor associated with the development of osteonecrosis is the use of glucocorticoid at high doses. Recent studies using serial MRI, which represents the “gold standard” for the early detection of osteonecrosis, yielded some interesting findings about the natural history of this clinical entity. Osteonecrosis in the majority of the cases is asymptomatic and occurs early in the course of the disease. Its later occurrence is associated with lupus flare that requires the increase of corticosteroid dose. The optimal treatment of osteonecrosis is controversial. In case of silent osteonecrosis involving a small area conservative strategy is usually adequate. When lesions are symptomatic surgical treatment as core decompression or free vascularized fibular grafting is required; extracorporeal shockwave treatment may represent an alternative therapeutic approach. When the lesion has a medium-large dimension or involves a weight-bearing area bone collapse is a common complication requiring total joint replacement. Coadministration of bisphosphonate or warfarin with high doses of corticosteroid might be a promising preventive strategy of osteonecrosis.

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“…The observed contrast is difficult to interpret. For most of patients in their study, steroid treatment was addressing an underlying disease, like systemic lupus erythematosus, that might have added to causing bone lesion [21]- [23]. However, corticotherapy is also incriminated in the genesis of aseptic osteonecrosis in SLE [15] [23].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Aseptic Osteonecrosis in Hospital Settings in Yaounde, Cameroon

Singwé–Ngandeu¹,

Younouss²,

Chemeni³

et al. 2015

OJRA

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Factors Associated With Osteonecrosis in Thai Lupus Patients

Abstract: The presence of renal involvement was associated with ON and the antimalarial use may have a protective effect for ON in Thai patients with SLE. The findings from this study further support the use of antimalarial drugs in SLE patients.

Cited by 24 publications

References 24 publications

Monitoring of Osteonecrosis in Systemic Lupus Erythematosus: A Systematic Review and Metaanalysis

Monitoring of Osteonecrosis in Systemic Lupus Erythematosus: A Systematic Review and Metaanalysis

Osteonecrosis in Systemic Lupus Erythematosus: An Early, Frequent, and Not Always Symptomatic Complication

Factors Associated with Aseptic Osteonecrosis in Hospital Settings in Yaounde, Cameroon

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