HIGH-DOSE INTRAVENOUS METHYLPREDNISOLONE THERAPY ASSOCIATED WITH OSTEONECROSIS IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS
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Date
1992
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Abstract
Osteonecrosis is related to the use of steroids in patients with systemic lupus erythematosus (SLE); its association with the use of 'pulses' of methylprednisolone (PMP) is not clear at present. In a retrospective analysis of 190 patients with SLE we found that 19% of 36 patients treated with PMP had osteonecrosis compared with 6% of 154 patients without that treatment (P < 0.04). Risk factors associated with osteonecrosis were PMP treatment, cushingoid appearance, steroid doses greater-than-or-equal-to 40 mg/day during the first month of treatment, a ratio of steroid dose in grams/year greater-than-or-equal-to 12, hematuria and proteinuria. In a stepwise regression model, when cushingoid appearance was excluded, PMP became the only significant factor (P = 0.045).
We conclude that osteonecrosis can be considered a long-term complication of PMP treatment in SLE patients.
We conclude that osteonecrosis can be considered a long-term complication of PMP treatment in SLE patients.
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Keywords
OSTEONECROSIS, METHYLPREDNISOLONE, SYSTEMIC LUPUS ERYTHEMATOSUS