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Risk factors for avascular necrosis in patients with systemic lupus erythematosus: a multi-center cohort study of Chinese SLE Treatment and Research Group (CSTAR) Registry XXII.
Cheng, Cheng; Huang, Can; Chen, Zhen; Zhan, Feng; Duan, Xinwang; Wang, Yongfu; Zhao, Cheng; Wu, Zhenbiao; Xu, Jian; Li, Hongbin; Yang, Min; Wu, Rui; Zhao, Jiuliang; Zhang, Shangzhu; Wang, Qian; Leng, Xiaomei; Tian, Xinping; Li, Mengtao; Zeng, Xiaofeng.
Affiliation
  • Cheng C; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Huang C; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Chen Z; Department of Rheumatology and Immunology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
  • Zhan F; Department of Rheumatology, Hainan General Hospital, Haikou, China.
  • Duan X; Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
  • Wang Y; Department of Rheumatology Institute of Immunology and Rheumatology Inner Mongolia Key Laboratory of Autoimmunity, The First Affiliated Hospital of Baotou Medical College, Baotou Medical College, Baotou, China.
  • Zhao C; Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
  • Wu Z; Department of Clinical Immunology and Rheumatology, Xijing Hospital Affiliated to the Fourth Military Medical University, Xi'an, China.
  • Xu J; Department of Rheumatology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
  • Li H; Department of Rheumatology, Affiliated Hospital of Inner Mongolia Medical College, Hohhot, China.
  • Yang M; Department of Rheumatology and Immunology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  • Wu R; Department of Rheumatology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
  • Zhao J; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Zhang S; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Wang Q; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Leng X; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Tian X; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Li M; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
  • Zeng X; Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Labora
Arthritis Res Ther ; 25(1): 78, 2023 05 12.
Article in En | MEDLINE | ID: mdl-37173771
ABSTRACT

BACKGROUND:

Avascular necrosis is a common organ damage in SLE patients, which can influence patients' life quality. Conflicting results exist in risk factors of AVN in SLE patients. The aim of this study was to illustrate risk factors predicting the occurrence of avascular necrosis (AVN), also known as osteonecrosis, in systemic lupus erythematosus (SLE) patients in Chinese SLE Treatment and Research Group (CSTAR), a multi-center cohort of Chinese SLE patients.

METHODS:

SLE patients in CSTAR without existing AVN at registration were included. At least two follow-ups and an observation period of no less than 2 years for AVN event were required. Univariate and multivariate Cox regression analyses were used to evaluate risk factors for AVN in SLE patients. Coefficient B was transformed to risk score for the development of a risk stratification model.

RESULTS:

One hundred six (2.59%) of 4091 SLE patients were diagnosed AVN during follow-ups of no less than 2 years. Multi-variate Cox regression analysis suggested that SLE onset age ≤ 30 (HR 1.616, p 0.023), arthritis (HR 1.642, p 0.018), existing organ damage (SDI ≥ 1) at registration (HR 2.610, p < 0.001), positive anti-RNP (HR 1.709, p 0.006), and high glucocorticoid maximum daily dose at registration (HR 1.747, p 0.02) were independent risk factors. A risk stratification system was developed according to the risk factors, and patients were divided into high risk (3-6) and low risk (0-2). The AUC of 0.692 indicated moderate discrimination. The calibration curve in internal validation was drawn.

CONCLUSION:

Patients with SLE onset age ≤ 30, arthritis, existing organ damage (SDI ≥ 1) at registration, positive anti-RNP, and high glucocorticoid maximum daily dose at registration are at high risk for AVN and require attention.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Osteonecrosis / Arthritis / Lupus Erythematosus, Systemic Type of study: Clinical_trials / Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Arthritis Res Ther Journal subject: REUMATOLOGIA Year: 2023 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Osteonecrosis / Arthritis / Lupus Erythematosus, Systemic Type of study: Clinical_trials / Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Arthritis Res Ther Journal subject: REUMATOLOGIA Year: 2023 Document type: Article