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Factors associated with osteonecrosis in Thai lupus patients: A case control study
Journal of Clinical Rheumatology (JCR), 10/07/09

Uea-areewongsa P et al. – 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.

Methods

Retrospective nested case-control study from SLE patients
Had clinically apparent ON (confirmed by plain radiographs or magnetic resonance imaging)
For each case, control was selected and matched to case by age and disease duration
Main outcome measure odds ratio (OR) of ON among SLE patients
Clinical and laboratory variables thought to be risk factors of ON variables were compared between patients who did and did not develop ON
Significant and clinically relevant variables examined by stepwise logistic regression model

Results

Of 186 SLE patients, 41 patients identified who developed ON during the course of follow-up
20patients available for data analysis
From the univariate analysis, incidence of renal involvement and use of steroids (recorded as evidenced by maximum and mean daily prednisolone dose) significantly higher in ON group than controls
Use of antimalarials significantly lower in patients with ON than in controls
No difference in disease activity, lipid profiles or anticardiolipin antibody found between groups
In logistic regression, presence of renal involvement remained as positive associated factor for ON (OR = 7.80, CI = 1.249-48.748) and the use of antimalarial drugs was a negative associated factor for ON (OR = 0.09, CI = 0.009-0.961)