Supplemental Material - Trends in all-cause hospitalizations for systemic lupus erythematosus in Mexico, 2000–2019

Supplemental Material for Trends in all-cause hospitalizations for systemic lupus erythematosus in Mexico, 2000–2019 by Claudia Mendoza-Pinto, Ivet Etchegaray-Morales, Pamela Munguía-Realpozo, Juan Carlos Solis-Poblano, Socorro Méndez-Martínez, Ángel David Osorio-Peña, Jorge Ayón-Aguilar, Mario García-Carrasco, and Carlos Abud-Mendoza in Lupus</p

Bone mineral density and vertebral fractures in patients with systemic lupus erythematosus: A systematic review and meta-regression

<div><p>Background</p><p>Observational studies have indicated a high but heterogeneous prevalence of low bone mineral density (BMD) and vertebral fractures (VF) in patients with systemic lupus erythematosus (SLE). Therefore, the objectives of this systematic review and meta-regression were: 1) to compare BMD between SLE patients and healthy controls and 2) to evaluate the relationship between BMD and glucocorticoid therapy and VF in SLE patients.</p><p>Methods and findings</p><p>Articles were identified from electronic databases (PubMed, Embase, VHL, SciELO and the Cochrane Library). Prospective longitudinal and cross-sectional studies were considered for review. We evaluated the quality of the evidence included using the Oxford Centre for evidence-based medicine (EBM) Levels of Evidence. In total, 38 articles were identified and analyzed (3442 SLE cases and 6198 controls) in the analysis of BMD (9232 women and 408 men). There were significant differences in mean BMD between SLE patients and controls. BMD mean difference in cases/controls: -0.0566 95% CI (-0.071, -0.0439; p = < 0.0001). When only SLE patients were analyzed, the BMD did not significantly differ between patients who had or had not received glucocorticoid (GCT) therapy. 694 SLE patients were included in the analysis of VF (189 with VF vs. 505 without VF). Patients with VF had lower BMD than patients without VF (BMD mean difference without VF/with VF: 0.033 (95%CI: 0.006–0.060); p-value: 0.0156).</p><p>Conclusions</p><p>Patients with SLE had lower BMD than healthy controls. Moreover, SLE patients with VF had lower BMD than patients without VF. However, our data did not show that GCT therapy had an impact on BMD.</p></div

Results of the most parsimonious models for the groups of studies.

<p>Results of the most parsimonious models for the groups of studies.</p

Characteristics of included studies comparing SLE with and without vertebral fractures.

<p>Characteristics of included studies comparing SLE with and without vertebral fractures.</p

Characteristics of studies included comparing SLE cases and controls.

<p>Characteristics of studies included comparing SLE cases and controls.</p