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Title of Journal: Rheumatol Int

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Abbravation: Rheumatology International

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Springer Berlin Heidelberg

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DOI

10.1016/j.amjmed.2015.10.029

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1437-160X

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Prevalence incidence and associated factors of a

Authors: Young Bin Joo YoonKyoung Sung JeeSeon Shim JaeHoon Kim EuiKyung Lee HyeSoon Lee SangCheol Bae
Publish Date: 2014/10/10
Volume: 35, Issue: 5, Pages: 879-886
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Abstract

Avascular necrosis AVN is one of the most frequent types of organ damage in systemic lupus erythematosus SLE However little is currently known about the epidemiology of AVN in SLE patients The aim of this study was to estimate the prevalence and incidence of AVN in Korean patients with SLE based on National Health Insurance NHI claims data and to determine the risk factors for AVN among SLE patients This study was conducted using the 2006–2010 data of 25358 SLE patients from the NHI program AVN cases were defined as those with at least one diagnosis of AVN The prevalence was calculated by dividing the number of AVN cases by the number of SLE cases in the same year The annual incidence was calculated by dividing the number of incident AVN cases by the number of SLEprevalent cases not previously diagnosed with AVN Patients who developed AVN in 2008–2010 were compared with SLE patients who did not develop AVN to identify any risk factors The prevalence of AVN among SLE patients 2006–2010 was 315–342 per 1000 persons and was similar in all the years studied The incidence per 1000 persons of AVN among SLE patients was 86 95  confidence interval 95  CI 69–103 in 2008 98 95  CI 80–116 in 2009 and 84 95  CI 68–100 in 2010 Regression analysis indicated that taking an oral corticosteroid odds ratio OR 212 95  CI 139–323 or an intravenous corticosteroid OR 15 95  CI 12–189 was significantly associated with AVN In addition AVN was associated with use of immunosuppressive agents OR 212 95  CI 166–272 hydroxychloroquine OR 14 95  CI 109–181 and lipidlowering agents OR 178 95  CI 124–257 among the prescribed medications and with hypertension OR 139 95  CI 108–179 among the comorbidities The prevalence and incidence of AVN among SLE patients which were 315–342 and 84–98 per 1000 persons respectively may be representative of the entire population of symptomatic AVN patients with SLE in Korea AVN is associated with the use of corticosteroids immunosuppressants hydroxychloroquine lipidlowering agents and with hypertension Studies of large prospective cohorts are needed to confirm these results

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