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Incidence of osteonecrosis associated with corticosteroid therapy among different underlying diseases: Prospective MRI study
Rheumatology, 08/25/2011
Clinical Article
Shigemura TI et al. – These findings suggest that the incidence of CS-associated osteonecrosis varies among different underlying diseases.
Methods- Prospectively used MRI 90%)
- Studied 337 eligible underlying disease patients requiring CS therapy and succeeded in examining 1199 joints (hips and knees) in 302 patients with MRI for at least 1 year starting immediately after onset of CS therapy (1-year follow-up rate of 90%)
- Underlying diseases included SLE in 687 joints (173 patients) and a variety of other rheumatological disorders in 512 joints (129 patients)
- Incidence of osteonecrosis was significantly higher in SLE patients than in non-SLE patients (37 vs 21%, P=0.001)
- Logistic regression analysis revealed that adolescent and adult patients had a significantly higher risk of osteonecrosis compared with paediatric patients [OR=13.2], that high daily CS dosage (>40mg/day) entailed significantly higher risk of osteonecrosis compared with the dosage of <40mg/day (OR=4.2), that SLE patients had a significantly higher risk of osteonecrosis compared with non-SLE patients (OR=2.6) and that male patients had a significantly higher risk of osteonecrosis compared with female patients (OR=1.6)
