This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (5) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Prasad, R Articles by Urowitz, M Search for Related Content PubMed PubMed Citation Articles by Prasad, R Articles by Urowitz, M Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Lupus Osteonecrosis Social Bookmarking                         What's this?

The role of non-corticosteroid related factors in osteonecrosis (ON) in systemic lupus erythematosus: a nested case-control study of inception patients

D Ibanez

D Gladman

University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

M Urowitz

University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada m.urowitz{at}utoronto.ca

Several factors have been associated with the development of osteonecrosis (ON) in SLE but corticosteroid (CS) therapy has been the most consistent association. We sought to determine factors that predisposed to, or protected from, the development of ON in lupus patients when cumulative oral corticosteroid doses were matched between cases and controls, thereby removing presence of corticosteroid therapy and cumulative dose as risk factors. A nested case-control study of an inception cohort of SLE patients was used to determine the clinical, laboratory and therapeutic differences between patients who developed their first ON event and patients who did not develop ON, having matched these groups for their cumulative oral corticosteroid doses. Of the 570 patients seen within the first year after diagnosis 65 (11.4%) developed ON. None of the variables examined were found to confer additional ON risk in multivariate analysis. It appears that the major factor associated with the development of ON is corticosteroid therapy. Factors which may protect a majority of patients on corticosteroids from developing ON remain to be elucidated.

Key Words: lupus • osteonecrosis • corticosteroids • risk factors

Lupus, Vol. 16, No. 3, 157-162 (2007)
DOI: 10.1177/0961203306075771


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				G Ruiz-Irastorza, M Ramos-Casals, P Brito-Zeron, and M A Khamashta Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review Ann Rheum Dis, January 1, 2010; 69(01): 20 - 28. [Abstract] [Full Text] [PDF]