Antiphospholipid antibodies and osteonecrosis in systemic lupus erythematosus: a meta-analysis

ABSTRACT

Objectives: The present meta-analysis aimed to assess the relationship between antiphospholipid antibodies (aPLs) or antiphospholipid antibody syndrome (APS) and the incidence of osteonecrosis (ON) in systemic lupus erythematosus (SLE) patients.

Methods: MEDLINE/Pubmed, EMBASE, Web of science, the Chinese Biomedical Literature Database (CBM), the Wan-Fang Database, and the China National Knowledge Infrastructure (CNKI) were searched from their inception up until 26 December 2020. Studies in English were included. Case–control studies and cohort studies were included. Studies pertaining to the link between aPLs or APS and ON patients were slated for inclusion in the current analysis.

Results: Twenty-two studies involving a total of 3054 SLE patients were included. The positivities of anticardiolipin antibody (ACL), IgG ACL, IgM ACL, LA and APS in SLE is not associated with ON. One study showed that IgG or IgM β2GP1 had no association with ON. No publication bias was detected. The quality of this evidence was low because of the high risk of bias across studies, and therefore robust inferences cannot be made.

Conclusion: SLE patients demonstrated a weak association between aPLs and ON. The nature of the association between aPLs and ON in SLE needs to be investigated in-depth in future research.

KEYWORDS:

• Antiphospholipid antibody
• antiphospholipid antibody syndrome
• meta-analysis
• osteonecrosis
• systemic lupus erythematosus

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

Thanks are due to Wei Wang for providing with literature knowledge and information in this paper.

Additional information

Funding

This work was supported by Natural Science Foundation of Fujian Province, Grant No.2019J01184.

Notes on contributors

Chen Zhihan

Chen Zhihan designed this topic and approved the final version of manuscript. Zhang Shengli, Gao Fei and Lin He helped to make the search strategy. Zhou Meng and Weiqijiao screened the title and abstracts, extracted the data and assessed the quality of the included studies independently. Liu Jianwen decided any disagreement.Wei Qijiao drafted the article.