Risk factors for avascular necrosis of bone in patients with systemic lupus erythematosus: Is there a role for antiphospholipid antibodies?

Mok, Mo Yin; Farewell, Vernon T.; Isenberg, David

doi:10.1136/ard.59.6.462

Cited by 99 publications

(89 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, not all patients in our study were tested. The prevalence of positive antiphospholipid antibodies in our study (15%) is lower than that reported in other series of SLE patients with osteonecrosis [1,14,[24][25][26] In a study comparing patients with osteonecrosis to those without osteonecrosis, an abrupt change in ratio of total cholesterol at one month was associated with development of osteonecrosis [19]. A clinical trial comparing atorvastatin to placebo in reducing incidence of osteonecrosis in steroid-treated lupus has been initiated [27].…”

Section: Discussioncontrasting

confidence: 48%

Systemic Lupus Erythematosus and Osteonecrosis: A Comparison of Patients with Single versus Multiple Joint Involvement

Kermani¹,

Crowson²,

Amrami

et al. 2010

Open Arth J

View full text Add to dashboard Cite

Abstract:Objective: The purpose of this study was to determine the clinical and laboratory features associated with osteonecrosis of multiple (>/= 3) joints in systemic lupus erythematosus (SLE). Methods:We included all patients with SLE and osteonecrosis evaluated at our institution between January 1, 2000 and June 30, 2006. The patients were divided into three groups based on osteonecrosis of 1 joint, 2 joints and 3 or more joints. Clinical features, laboratory findings and therapies of patients in these groups were compared using Fischer's exact test and rank sum tests.Results: Our study included 4 men and 37 women. Twelve patients (29.3%) had osteonecrosis of 1 joint, 16 patients (39%) had osteonecrosis of 2 joints and 13 patients (31.7%) had osteonecrosis of 3 or more joints. The only clinical feature of SLE significantly associated with osteonecrosis of 3 or more joints was central nervous system (CNS) disease (p = 0.01). The median cumulative and peak corticosteroid doses were similar in all 3 groups (p = 0.70 and p = 0.11 respectively). There were no differences in the frequency of anti-cardiolipin antibodies.Conclusions: History of CNS disease was the only variable associated with multiple joint osteonecrosis in patients with SLE. We found no association between corticosteroid doses and multiple joint osteonecrosis.

show abstract

Section: Discussioncontrasting

confidence: 48%

Systemic Lupus Erythematosus and Osteonecrosis: A Comparison of Patients with Single versus Multiple Joint Involvement

Kermani¹,

Crowson²,

Amrami

et al. 2010

Open Arth J

View full text Add to dashboard Cite

show abstract

“…APS antibodies as a prothrombotic factor might predispose to ION by causing microvascular thrombosis. However, the link between APS antibodies and ION is controversial [38][39][40][41]. In our study, there was no signiicant association between APS antibody and ION [32].…”

Section: Early Changes In Mri Features and Laboratory Parameters Of Scontrasting

confidence: 46%

Idiopathic Osteonecrosis and Atypical Femoral Fracture in Systemic Lupus Erythematosus

Kuroda¹,

Sato²

2017

Lupus

View full text Add to dashboard Cite

Osteonecrosis and osteoporosis are frequent adverse efects of glucocorticoid therapy of systemic lupus erythematosus (SLE). Idiopathic osteonecrosis (ION) of the femoral head occurs in 3-40% of patients receiving glucocorticoid, and can also develop in other bones. Higher doses of glucocorticoid and steroid pulse therapy are considered to be risk factors for ION of the femoral head. To analyze these risk factors, it seems important to detect early changes in the femoral head by magnetic resonance imaging and to monitor early clinical events atributable to steroid therapy. Prophylaxis with statins and warfarin remains debatable. The use of glucocorticoid is increase the risk of bone fractures. Bisphosphonate (BP) is used for its prevention and treatment of osteoporosis. Atypical femoral fracture (AFF) has been recently recognized as a complication associated with BP use. AFF is considered to be a form of stress fracture; localized periosteal thickening of the lateral cortex is often present at the fracture site. The thickening has been recently recognized as a complication associated with the use of antiresorptive agents such as BP and denosumab. As long-term BP/glucocorticoid use is a risk factor for beaking in patients with SLE , temporary withdrawal of BP administration should be considered.

show abstract

“…The antiphospholipid antibodies have recently been associated with AVN in patients with SLE. There are conflicting data on the role of antiphospholipid antibodies in SLE; some data support [8,18] an association, while other data do not [13]. The retrospective study by Asherson et al [18] showed that the prevalence of the antiphospholipid antibodies (anticardiolipin antibodies or lupus anticoagulant) was higher in SLE patients with AVN than in those without.…”

Section: Discussionmentioning

confidence: 95%

“…pulse steroid and AVN. Mok et al [13] reported that high-dose steroid administered within the first 4 months, the peak and the mean daily prednisolone dosage are independent risk factors for AVN. However, there are reports of patients with SLE complicated by AVN who had not been taking corticosteroid [14,15].…”

Section: Discussionmentioning

confidence: 98%

Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus

Sayarlıoğlu

İnanç

et al. 2010

Rheumatol Int

View full text Add to dashboard Cite

The objective was to investigate the predictive factors for avascular necrosis (AVN) of bone in patients with systemic lupus erythematosus (SLE). The records of 868 patients with SLE from four centers were reviewed retrospectively. Forty-nine patients with AVN were identified. A total of 154 patients with SLE who did not have clinically apparent AVN during the follow-up were evaluated as a control group. The demographic, clinical, laboratory and management characteristics of these two groups of patients were recorded according to predefined protocol and compared. The prevalence of AVN was detected 6% in our SLE population. The highest dose corticosteroid administered within 4 months and total cumulative prednisolone dose were significantly higher in the SLE patients with AVN. The use of cytotoxic agent significantly higher proportion of patients with AVN. AVN tends to develop more frequently in male gender and younger patients. Oral ulcer, pleuritis, Raynaud's phenomenon, cutaneous vasculitis, lymphadenopathy, autoimmune thyroiditis, peripheral neuropathy and Sjögren's syndrome were higher incidence in SLE patients with AVN. The bilateral femoral heads were the commonest site of involvement of AVN in our patients with SLE.

show abstract

Risk factors for avascular necrosis of bone in patients with systemic lupus erythematosus: Is there a role for antiphospholipid antibodies?

Cited by 99 publications

References 23 publications

Systemic Lupus Erythematosus and Osteonecrosis: A Comparison of Patients with Single versus Multiple Joint Involvement

Systemic Lupus Erythematosus and Osteonecrosis: A Comparison of Patients with Single versus Multiple Joint Involvement

Idiopathic Osteonecrosis and Atypical Femoral Fracture in Systemic Lupus Erythematosus

Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus

Contact Info

Product

Resources

About