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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus
Annals of the rheumatic diseases, v 70(10), pp 1726-1732
01 Oct 2011
PMID: 21893582
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Abstract
Objective Neuropsychiatric events occur unpredictably in systemic lupus erythematosus (SLE) and most biomarker associations remain to be prospectively validated. This study examined a disease inception cohort of 1047 SLE patients to determine which autoantibodies at enrolment predicted subsequent neuropsychiatric events. Methods Patients with a recent SLE diagnosis were assessed prospectively for up to 10 years for neuropsychiatric events using the American College of Rheumatology case definitions. Decision rules of graded stringency determined whether neuropsychiatric events were attributable to SLE. Associations between the first neuropsychiatric event and baseline autoantibodies (lupus anticoagulant (LA), anticardiolipin, anti-β2 glycoprotein-I, anti-ribosomal P and anti-NR2 glutamate receptor) were tested by Cox proportional hazards regression. Results Disease duration at enrolment was 5.4±4.2 months, follow-up was 3.6±2.6 years. Patients were 89.1% female with mean (±SD) age 35.2±13.7 years. 495/1047 (47.3%) developed one or more neuropsychiatric event (total 917 events). Neuropsychiatric events attributed to SLE were 15.4% (model A) and 28.2% (model B). At enrolment 21.9% of patients had LA, 13.4% anticardiolipin, 15.1% anti-β2 glycoprotein-I, 9.2% anti-ribosomal P and 13.7% anti-NR2 antibodies. LA at baseline was associated with subsequent intracranial thrombosis (total n=22) attributed to SLE (model B) (HR 2.54, 95% CI 1.08 to 5.94). Anti-ribosomal P antibody was associated with subsequent psychosis (total n=14) attributed to SLE (model B) (HR 3.92, 95% CI 1.23 to 12.5, p=0.02). Other autoantibodies did not predict neuropsychiatric events. Conclusion In a prospective study of 1047 recently diagnosed SLE patients, LA and anti-ribosomal P antibodies are associated with an increased future risk of intracranial thrombosis and lupus psychosis, respectively.
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Details
- Title
- Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus
- Creators
- J G Hanly - Dalhousie UniversityM B Urowitz - University of TorontoL Su - MRC Biostatistics UnitS-C Bae - Hanyang UniversityC Gordon - University of BirminghamA Clarke - McGill UniversityS Bernatsky - McGill UniversityA Vasudevan - SUNY Downstate Health Sciences UniversityD Isenberg - UCL AustraliaA Rahman - UCL AustraliaD J Wallace - University of California, Los AngelesP R Fortin - University of TorontoD Gladman - University of TorontoJ Romero-Dirz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránJ Sanchez-Guerrero - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránM A Dooley - University of North Carolina at Chapel HillI Bruce - University of ManchesterK Steinsson - National University Hospital of IcelandM Khamashta - King's College LondonS Manzi - University of PittsburghR Ramsey-Goldman - Northwestern UniversityG Sturfelt - Lund UniversityO Nived - Lund UniversityR van Vollenhoven - Karolinska InstitutetM Ramos-Casals - Universitat de BarcelonaC Aranow - Columbia UniversityM Mackay - Columbia UniversityK Kalunian - University of California, San DiegoG S Alarcón - University of Alabama at BirminghamB J Fessler - University of Alabama at BirminghamG Ruiz-Irastorza - University of the Basque CountryM Petri - Johns Hopkins UniversityS Lim - Emory UniversityD Kamen - Medical University of South CarolinaC Peschken - University of ManitobaV Farewell - University of CambridgeK Thompson - Dalhousie UniversityC Theriault - Dalhousie UniversityJ T Merrill - Oklahoma Medical Research Foundation
- Publication Details
- Annals of the rheumatic diseases, v 70(10), pp 1726-1732
- Publisher
- British Medical Journal (BMJ)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000294491600005
- Scopus ID
- 2-s2.0-80052444139
- Other Identifier
- 991021933897204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology