Trends in avascular necrosis and related arthroplasties in hospitalized patients with systemic lupus erythematosus and rheumatoid arthritis
Authors' conclusion
We report a breakpoint in rising SLE-AVN after 2011, which may relate to newer steroid-sparing therapies (i.e., belimumab). AVN-associated arthroplasties decreased in SLE and RA. Fewer AVN-associated arthroplasties were noted for Black patients and those with Medicaid, indicating potential disparities.
Study context
- Population
- Hospitalized adults with systemic lupus erythematosus (SLE) and RA, U.S. National Inpatient Sample 2000–2019, identified by ICD codes
- Participants
- 42,728 vs 43,600
- Exposure
- SLE vs RA hospitalizations, with or without avascular necrosis (AVN)
- SLE-AVNn = 42,728
- RA-AVNn = 43,600
- Outcome
- AVN and AVN-related arthroplasty rates and time trends (APC) in SLE and RA
Methodological detailsU.S. National Inpatient Sample (2000-2019), Joinpoint regression
- U.S. National Inpatient Sample (2000-2019)
- Joinpoint regression
Main finding
As reported in the abstract
AVN and AVN-related arthroplasty rates and trends
| Group | Value | Arthroplasties | AVN annual percent change (APC) 2000-2011 | AVN APC 2011-2019 | Arthroplasty APC | AVN APC |
|---|---|---|---|---|---|---|
| SLE-AVN | 1.3 % | 16,724 (39 %) | 1.94* | −2.03 | −2.03* | |
| RA-AVN | 0.5 % | 25,210 (58 %) | −0.82* | 0.98* |
Value
SLE-AVN1.3 %
RA-AVN0.5 %
Arthroplasties
SLE-AVN16,724 (39 %)
RA-AVN25,210 (58 %)
AVN annual percent change (APC) 2000-2011
SLE-AVN1.94*
RA-AVN— not stated in the abstract
AVN APC 2011-2019
SLE-AVN−2.03
RA-AVN— not stated in the abstract
Arthroplasty APC
SLE-AVN−2.03*
RA-AVN−0.82*
AVN APC
SLE-AVN— not stated in the abstract
RA-AVN0.98*
Observational data: associations, not effects.
Further findings
Characteristics of AVN hospitalizations and arthroplasties
- AVN hospitalizations: younger and of Black race
- Arthroplasties less likely in Black race or Medicaid coverage
Original publication
Trends in avascular necrosis and related arthroplasties in hospitalized patients with systemic lupus erythematosus and rheumatoid arthritis. Semin Arthritis Rheum. Published 10 April 2024. doi:10.
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