Risk factors of osteonecrosis in patients with systemic lupus erythematosus: a meta-analysis

Background This study aimed to explore risk factors for osteonecrosis in patients with systemic lupus erythematosus by meta-analysis. Methods PubMed, Embase, Web of Science, and Cochrane Library were searched for case–control/cohort studies on the occurrence of osteonecrosis in patients with systemic lupus erythematosus from the time the database was created until 1 December 2024. Data were analyzed using Stata 15.0, and the quality of the included studies was evaluated using the NOS score. Result A total of 14 articles, including 3,890 patients, were included in the study, and the meta-analysis indicates that younger age in SLE patients [SMD = −0.23, 95% CI (−0.39, −0.06)], diabetes mellitus [OR = 1.78, 95% CI (1.03, 3.09)], hypertension [OR = 1.33, 95% CI (1.03, 1.72)], arthritis [OR = 1.57, 95% CI (1.24, 2.00)], Raynaud’s phenomenon [OR = 1.76, 95% CI (1.35, 2.30)], and cyclophosphamide use [OR = 2.24, 95% CI (1.38, 3.63)] are risk factors for the development of osteonecrosis in patients with SLE. Conclusion The current study found that younger age, hypertension, diabetes, arthritis, Raynaud’s phenomenon, and cyclophosphamide use are independent risk factors for the development of osteonecrosis in patients with SLE.