Glucocorticoid‐induced osteonecrosis in systemic lupus erythematosus patients

Kaneko, Kaichi; Chen, Hao; Kaufman, Matthew; Sverdlov, Isaak; Stein, Emily; Park‐Min, Kyung‐Hyun

doi:10.1002/ctm2.526

Cited by 16 publications

(7 citation statements)

References 213 publications

(556 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Osteoporosis and secondary fractures are well-known risks in patients with SLE and are multifactorial, reflecting not only use of CS but persisting inflammation, physical inactivity and vitamin D insufficiency [ 26 ]. For osteonecrosis, the high HR for patients on CS, especially high doses, reflect the strong association, also highlighted in previous studies [ 27 , 28 ]. However, we also show steroid doses of <5 mg/day to associate with osteonecrosis development.…”

Section: Discussionsupporting

confidence: 70%

Glucocorticoid treatment in SLE is associated with infections, comorbidities and mortality—a national cohort study

Frodlund

Jönsen

Remkus³

et al. 2023

Rheumatology

View full text Add to dashboard Cite

Objectives Patients with SLE have an increased risk of comorbidities and impaired survival. We aimed to assess if various thresholds of oral corticosteroids (OCS) can predict development of infections, comorbidities, malignancies and survival in SLE using data from national health registries in Sweden. Methods All incident SLE cases, age >18 years, in Sweden (n = 5309) between 2005 and 2020 and matched population controls (n = 26545) were included and followed until 2020, total 257 942 patient years. Data from national registers were retrieved including information from the National Prescribed Drug Register. Risk factors were analysed using time-dependent Cox regression models. Results Compared with no OCS, >0 to < 5.0 mg/day, 5.0–7.5 mg/day as well as > 7.5 mg OCS/day predicted development of infections (pneumonia, influenza, herpes zoster and urinary tract infection), osteoporosis, osteonecrosis, gastroduodenal ulcers, cataracts, hypertension and mortality (all p< 0.05). OCS >0 to < 5.0 mg/day was associated with lower hazard ratios for these comorbidities than higher doses of OCS. Fifteen years after diagnosis, 48% of patients were taking OCS at a median dose of 5.7 mg/day. A small reduction of OCS treatment 5 years after diagnosis in patients diagnosed with SLE 2006–2010 compared with 2011–2015 was observed, 49% vs. 46% respectively (p= 0.039). Conclusion Results highlight the potential harm associated with even low OCS dose treatment in SLE and the need to judiciously use OCS at the lowest possible dose to maximize efficacy and minimize harm.

show abstract

Section: Discussionsupporting

confidence: 70%

Glucocorticoid treatment in SLE is associated with infections, comorbidities and mortality—a national cohort study

Frodlund

Jönsen

Remkus³

et al. 2023

Rheumatology

View full text Add to dashboard Cite

show abstract

“…Autoantibodies in SLE patients can attack their cells and tissues, forming antigen-antibody complexes that are deposited in the vascular wall, glomerular basement membrane, and other areas, eventually leading to target organ function damage [ 9 , 10 ]. Glucocorticoids combined with cyclophosphamide have anti-inflammatory and anti-T-lymphocyte proliferation effects, which can alleviate the clinical symptoms of patients [ 11 , 12 ]. However, in the process of conventional drug treatment, it will inhibit the body's immune function and the resulting cytotoxicity, resulting in a poor anti-inflammatory effect.…”

Section: Discussionmentioning

confidence: 99%

Effects of DNA Immunoadsorption Combined with Medication on Immune Function and Renal Function in Patients with Systemic Lupus Erythematosus

Bai

Sun

et al. 2023

Journal of Environmental and Public Health

View full text Add to dashboard Cite

Objective. At present, glucocorticoids combined with cyclophosphamide are still used for the clinical treatment of systemic lupus erythematosus (SLE). However, long-term practice has shown that drug treatment currently has the phenomena of long treatment duration, uncontrollable conditions in a short period of time, and unsatisfactory efficacy. DNA immunoadsorption therapy is a newly developed therapy. The combination of drugs and DNA immunoadsorption has been reported for the treatment of SLEN in clinics for a long time. In this study, we observed the effects of DNA immunoadsorption combined with drug therapy on immune function and renal function in patients with systemic lupus erythematosus (SLE). The results showed that the DNA immunosorbent assay combined with medication in the treatment of SLE could quickly and specifically remove pathogenic substances from patients, improve renal function, immune function, and complement levels in patients, and help to relieve disease activity.

show abstract

“…Disease-related features, including Raynaud's phenomenon and vasculitis, increase the risk of ON lesions among patients with SLE [71]. Furthermore, age at the time of the start of glucocorticoids is associated with ON in pediatric patients with SLE [72].…”

Section: Glucocorticoids and The Bonementioning

confidence: 99%

“Neuroimmunoendocrinology” in Children with Rheumatic Diseases: How Glucocorticoids Are the Orchestra Director

Maggio,

Miniaci,

Gallizzi

et al. 2023

IJMS

View full text Add to dashboard Cite

The neural, the endocrine, and the immune systems are studied as distinct districts in physiological and pathological settings. However, these systems must be investigated with an integrative approach, while also considering that therapeutic agents, such as glucocorticoids, can induce a reversible or irreversible change of this homeostasis. Children and adolescents affected by rheumatic diseases frequently need treatment with corticosteroids, and the treatment must sometimes be continued for a long time. In the biological era, the treat-to-target strategy allowed a real revolution in treatment, with significant steroid dose sparing or, in many patients, steroid treatment withdrawal. In this review, the impact of glucocorticoids on endocrine, immune, and neurologic targets is analyzed, and the crosstalk between these systems is highlighted. In this narrative review, we explore the reasoning as to why glucocorticoids can disrupt this homeostasis, we summarize some of the key results supporting the impact of glucocorticoids treatment on endocrine, immune, and neurologic systems, and we discuss the data reported in the international literature.

show abstract

Glucocorticoid‐induced osteonecrosis in systemic lupus erythematosus patients

Cited by 16 publications

References 213 publications

Glucocorticoid treatment in SLE is associated with infections, comorbidities and mortality—a national cohort study

Glucocorticoid treatment in SLE is associated with infections, comorbidities and mortality—a national cohort study

Effects of DNA Immunoadsorption Combined with Medication on Immune Function and Renal Function in Patients with Systemic Lupus Erythematosus

“Neuroimmunoendocrinology” in Children with Rheumatic Diseases: How Glucocorticoids Are the Orchestra Director

Contact Info

Product

Resources

About