Musculoskeletal complications of systemic lupus erythematosus in the hopkins lupus cohort: An update

Authors

  • Michelle Petri MD, MPH

    Associate Professor, Corresponding author
    1. Division of Molecular and Clinical Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD
    • Division of Molecular and Clinical Rheumatology, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 7500, Baltimore, MD 21203
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Abstract

Objective. To determine the frequency of musculoskeletal system damage among patients in the Hopkins Lupus Cohort, over time, and to determine predictors of musculoskeletal damage [including avascular necrosis of bone, osteoporosis, and fracture] in the same cohort.

Methods. Evaluation of the cohort visit database [from 1989 or at the time of entry into the cohort if later than 1989] for the 407 patients with systemic lupus erythematosus [SLE]. Musculoskeletal damage was measured by the SLICC/ACR Damage Index.

Results. Total damage and musculoskeletal damage accumulated from the time of diagnosis of SLE, and musculoskeletal damage continued over time, with avascular necrosis of bone being the most common form. African-Americans and SLE patients of lower socioeconomic status were more likely to experience musculoskeletal damage. Use of corticosteroids was a major risk factor for both avascular necrosis of bone and osteoporosis.

Conclusio. Musculoskeletal damage remains one of the major sequela of SLE. Reduction of the modifiable risk factors [especially prednisone dose] is the key to both primary and secondary prevention efforts.

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