TY - JOUR T1 - Systemic Lupus Erythematosus, Osteoporosis, and Fractures JF - The Journal of Rheumatology JO - J Rheumatol SP - 1913 LP - 1915 DO - 10.3899/jrheum.140919 VL - 41 IS - 10 AU - JONATHAN D. ADACHI AU - ARTHUR LAU Y1 - 2014/10/01 UR - http://www.jrheum.org/content/41/10/1913.abstract N2 - Osteoporosis is a common yet less-recognized complication of systemic lupus erythematosus (SLE) that has been brought to our attention by Zhu, et al’s article in this issue of The Journal1. Recent studies, however, have highlighted the high prevalence of fractures in a relatively young population of women suffering from SLE1,2,3,4,5,6,7. There have been many studies reporting different results. This might be explained by the complex relationship between SLE, complications of the disease itself or its treatment, duration of disease, bone loss, and fractures. Indeed the systemic inflammation associated with SLE and the resultant end-organ damage may all play a role1,2,3. Combine this with the traditional risk factors for fracture and it is easy to understand why the study of osteoporosis and fractures in SLE is complex.Confounders include active inflammation and treatment of inflammation with glucocorticoids1,2,3, menopausal status, and disease-associated complications such as renal bone disease and neuropsychiatric disease3. Other non-SLE risk factors including age, medications such as selective serotonin receptor inhibitors (SSRI) and possibly proton pump inhibitors (PPI) may all confound the relationship between SLE and fractures. The effect of treatment with bone-active drugs to prevent bone loss and fractures must also be taken into consideration in studies of SLE. Inflammation There is … Address correspondence to Dr. Adachi, St. Joseph’s Hospital, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: jd.adachi{at}sympatico.ca ER -