RESEARCH - Prospective study of neuropsychiatric events in SLE

May 28, 2009

J Rheumatol. 2009 May 15.

Prospective Study of Neuropsychiatric Events in Systemic Lupus Erythematosus.

Hanly JG, Su L, Farewell V, McCurdy G, Fougere L, K.

From the Division of Rheumatology, Department of Medicine and

Department of Pathology, Queen II Health Sciences Centre and

Dalhousie University, Halifax, Nova Scotia, Canada; and MRC

Biostatistics Unit, Institute of Public Health, University of

Cambridge, Forvie Site, Cambridge, UK.

OBJECTIVE: To prospectively examine neuropsychiatric (NP) events and

their association with health related quality of life (HRQOL) over

time in patients with systemic lupus erythematosus (SLE).

METHODS: In an observational cohort study from a single academic

center, NP events and their attribution were identified at enrollment

and at annual assessments for up to 7 years. NP events were

characterized using the American College of Rheumatology case

definitions; other variables were global SLE disease activity and

cumulative organ damage. The outcomes of NP events were recorded and

self-report HRQOL was measured with the mental (MCS) and physical

(PCS) component summary scores of the Medical Outcomes Study Short

Form-36.

RESULTS: There were 209 patients, 88% female and 92% Caucasian, with a

mean (standard deviation) age of 43.7 (13.8) years. Followup was

available in 175/209 (84%) patients. There were 299 NP events in

132/209 (63%) patients over a mean followup of 3.6 (2.5) years.

Thirty-one percent of NP events in 54 patients were attributed to SLE.

Multivariate analysis indicated lower MCS scores in patients with NP

events compared to those without events (p < 0.001) regardless of

attribution. The group means for PCS scores were significantly lower

in patients with NP events (p < 0.001) regardless of attribution.

There was no association between HRQOL and cumulative organ damage,

nor between NP events and the progression of organ damage.

CONCLUSION: The association of lower HRQOL with NP events over time,

which is independent of progression in cumulative organ damage,

emphasizes the persistent negative effect of NP events in the lives of

patients with SLE.

PMID: 19447937

Not an MD

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