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  • Abstract The effect of varying corticosteroid regimens on hip osteonecrosis incidence remains unclear. We performed a meta-analysis and systematic literature review to determine osteonecrosis occurrences in patients taking corticosteroids at varying mean and cumulative doses and treatment durations, and whether medical diagnoses affected osteonecrosis incidence. Fifty-seven studies (23,561 patients) were reviewed. Regression analysis determined significance between corticosteroid usage and osteonecrosis incidence. Osteonecrosis incidence was 6.7% with corticosteroid treatment of >2 g (prednisone-equivalent). Systemic lupus erythematosus patients had positive correlations between dose and osteonecrosis incidence. Each 10 mg/d increase was associated with a 3.6% increase in osteonecrosis rate, and >20 mg/d resulted in a higher osteonecrosis incidence. Clinicians must be wary of osteonecrosis in patients on high corticosteroid regimens, particularly in systematic lupus erythematosus.
Subject
  • Steroids
  • Corticosteroids
  • Endocrinology
  • Osteonecrosis
  • Risk factors
  • Meta-analysis
  • Systematic review
  • Steroid hormones
  • Hormones
  • Diving medicine
  • Evidence-based practices
  • Medical statistics
  • Osteopathies
  • RTT
  • RTTEM
  • World Anti-Doping Agency prohibited substances
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