RT Journal Article SR Electronic T1 Monitoring of Osteonecrosis in Systemic Lupus Erythematosus Patients: A Systematic Review and Metaanalysis JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP jrheum.170837 DO 10.3899/jrheum.170837 A1 Sara Hussein A1 Manon Suitner A1 Sarah Béland-Bonenfant A1 Alexandra Baril-Dionne A1 Ben Vandermeer A1 Nancy Santesso A1 Stephanie Keeling A1 Janet E. Pope A1 Aurore Fifi-Mah A1 Josiane Bourré-Tessier YR 2018 UL http://www.jrheum.org/content/early/2018/06/21/jrheum.170837.abstract AB Objective Nontraumatic osteonecrosis (ON) is a well-recognized complication causing disability and affecting quality of life in patients with systemic lupus erythematosus (SLE). The aim of this study was to identify the risk factors for ON, and to identify the minimal investigation(s) needed to optimally monitor the risk of ON in patients with SLE. Methods A systematic review was conducted using MEDLINE and EMBASE. These databases were searched up to January 2016 using the Medical Subject Heading (MeSH) terms “Osteonecrosis,” “Systemic lupus erythematosus,” and synonymous text words. Randomized controlled trials, case control, cohort, and cross-sectional studies were included. Risk factors for ON in patients with SLE were compiled. The quality of each study was assessed using the Newcastle-Ottawa scale for nonrandomized studies. The quality of evidence of each risk factor was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation method. Results Of the 545 references yielded, 50 met inclusion criteria. Corticosteroid (CS) use may be strongly associated with ON in patients with SLE. Other clinical variables were moderately associated, including hypertension, serositis, renal disease, vasculitis, arthritis, and central nervous system disease. However, the evidence was low to very low in quality. Conclusion Based on the best evidence available, CS use may be strongly associated with ON in patients with SLE. Results of this review were considered in the development of recommendations for the diagnosis and monitoring of patients with SLE in Canada and will guide clinicians in their assessment of these patients.