Jiang et al reported a model predictive of osteonecrosis in a patient treated with glucocorticoids. The authors are from Fudan University in Shanghai.
Patient selection: therapy with glucocorticoids
Parameters:
(1) explained variance weighted genetic risk score (EV-GRS, based on NOTCH 3, ARHGEF38, DGKD, SLC5A10, and EFNA1), with values usually in the range from -10 to 25
(2) age at start of glucocorticoid therapy
(3) sex
(4) risk associated with underlying diseases
|
Parameter
|
Finding
|
Points
|
|
EV-GRS
|
|
0.97 * (EV-GRS)
|
|
sex
|
female
|
0
|
|
|
male
|
-1.94
|
|
age
|
< 40 years
|
0
|
|
|
>= 40 years
|
-1.57
|
|
underlying disease
|
high risk
|
0
|
|
|
low risk
|
-3.59
|
|
|
unknown risk
|
1.55
|
where:
• High risk: SLE and adult-onset Still's disease
• Low risk: primary vasculitis, acute kidney injury, Sjogren's syndrome, Behcet's disease, retroperitoneal fibrosis
• Unknown risk: everything else.
• The OR for unknown risk as underlying disease was 4.71 vs 1 for high risk.
value of X =
= SUM(points for the parameters) + 3.26
probability of osteonecrosis of the femoral head =
= 1 / (1 + EXP((-1) * X))
