Vasculitis & polymyalgia rheumatica
Prevalence and risk factors of osteonecrosis of the femoral head in patients with ANCA-associated vasculitis: a multicentre cohort study
Authors' conclusion
Eighteen per cent of AAV patients developed ONFH, and two-thirds of the ONFH joints were already in collapse stages or at risk of future collapse. Prednisolone dose of ≥20 mg/day on day 90 of RIT was an independent risk factor for ONFH.
Study context
- Population
- Antibody-associated vasculitis (AAV) patients who underwent radiographs and MRI screening of bilateral hip joints >6 months after initial remission induction therapy (RIT)
- Participants
- 186 patients
- Outcome
- Prevalence of osteonecrosis of the femoral head (ONFH)
- Follow-up
- >6 months after initial RIT
Methodological detailsmulticentre, retrospective assessment
- Multicentre
- Retrospective assessment
Main finding
As reported in the abstract
ONFH prevalence
Patients diagnosed with osteonecrosis of the femoral head (ONFH)
33
18%
Observational data: associations, not effects.
Further findings
Risk factor: prednisolone ≥20 mg/day on day 90 of RIT
| OR (95% CI) | P value | ||
|---|---|---|---|
| Prednisolone ≥20 mg/day on day 90 of RITIndependent risk factor | 1.072 (1.017–1.130) | P = 0.009 | |
| 0.512Odds ratio (log scale) |
ONFH characteristics
- Asymptomatic, among ONFH patients
- 55%
- Bilateral ONFH, among ONFH patients
- 64%
- ONFH joints in precollapse stages (stage ≤2)
- 76%
- ONFH joints in collapse stages (stage ≥3)
- 24%
- Precollapse joints at risk of future collapse (type ≥C-1)
- 56%
- Precollapse joints type ≥C-1 in asymptomatic ONFH patients
- 39%
Rituximab use and ONFH
- Significant beneficial factor against ONFH
- P = 0.019
- Not significant in multivariate analysis
- P = 0.257
Original publication
Prevalence and risk factors of osteonecrosis of the femoral head in patients with ANCA-associated vasculitis: a multicentre cohort study. RMD Open. Published 27 February 2023. doi:10.
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