This query form appears in the slow log for wikidatawiki on WMF S5:
SELECT /* Wikibase\EntityPerPageTable::getItemsWithoutSitelinks ? */ epp_entity_id AS entity_id FROM `wb_entity_per_page` LEFT JOIN `wb_items_per_site` ON ((ips_item_id = epp_entity_id)) WHERE (ips_site_page IS NULL) AND epp_entity_type = 'item' ORDER BY epp_page_id DESC LIMIT 1940000, 51;
Offset 1940000... wow! :-)
Can we cap the possible limit offset, or handle pagination differently?