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Investigation of occurrence of osteonecrosis of the femoral head after increasing corticosteroids in patients with recurring systemic lupus erythematosus
Rheumatology International, 10/12/09

Sekiya F et al. –Findings suggest that increased serum lipid levels might be a contributing factor to onset of ON. Moreover, SLE disease activity index 2000 (SLEDAI-2K) scores SLE disease activity index 2000 (SLEDAI-2K) scores when the CS dose was increased were significantly (P < 0.05) higher in the ON group, suggesting that SLE disease activity itself is a risk factor for onset of ON.

Methods

Included 17 patients who experienced recurrence of SLE for at least 1 year at our hospital and in whom the CS dose was increased from maintenance dose to middle to high dose to see if ON would occur
Compared group that developed ON and group that did not with respect to patient characteristics, blood test results, changes in serum lipid levels, and CS dose

Results

ON occurred in 5 subjects (29.4%), revealing that osteonecrosis occurs not only when CS are first administered but also when CS dose increased for recurrence of SLE
Serum cholesterol levels and its rate of increase soared rapidly soon after increasing CS dose in ON group as compared with non-ON group

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