Journal article
Headache in Systemic Lupus Erythematosus Results From a Prospective, International Inception Cohort Study
Arthritis and rheumatism, v 65(11), pp 2887-2897
Nov 2013
PMID: 24166793
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
ObjectiveTo examine the frequency and characteristics of headaches and their association with global disease activity and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE).
MethodsA disease inception cohort was assessed annually for headache (5 types) and 18 other neuropsychiatric (NP) events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 (SF-36) mental and physical component summary scores were collected. Time to first headache and associations with SF-36 scores were analyzed using Cox proportional hazards and linear regression models with generalized estimating equations.
ResultsAmong the 1,732 SLE patients enrolled, 89.3% were female and 48.3% were white. The mean SD age was 34.6 +/- 13.4 years, duration of disease was 5.6 +/- 5.2 months, and length of followup was 3.8 +/- 3.1 years. At enrollment, 17.8% of patients had headache (migraine [60.7%], tension [38.6%], intractable nonspecific [7.1%], cluster [2.6%], and intracranial hypertension [1.0%]). The prevalence of headache increased to 58% after 10 years. Only 1.5% of patients had lupus headache, as identified in the SLEDAI-2K. In addition, headache was associated with other NP events attributed to either SLE or non-SLE causes. There was no association of headache with SLEDAI-2K scores (without the lupus headache variable), SDI scores, use of corticosteroids, use of antimalarials, use of immunosuppressive medications, or specific autoantibodies. SF-36 mental component scores were lower in patients with headache compared with those without headache (mean +/- SD 42.5 +/- 12.2 versus 47.8 +/- 11.3; P < 0.001), and similar differences in physical component scores were seen (38.0 +/- 11.0 in those with headache versus 42.6 +/- 11.4 in those without headache; P < 0.001). In 56.1% of patients, the headaches resolved over followup.
ConclusionHeadache is frequent in SLE, but overall, it is not associated with global disease activity or specific autoantibodies. Although headaches are associated with a lower HRQOL, the majority of headaches resolve over time, independent of lupus-specific therapies.
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Details
- Title
- Headache in Systemic Lupus Erythematosus Results From a Prospective, International Inception Cohort Study
- Creators
- John G. Hanly - Queen Elizabeth II Health Sciences CentreMurray B. Urowitz - Toronto Western HospitalAidan G. O'Keeffe - Inst Publ Hlth, Cambridge, EnglandCaroline Gordon - University of BirminghamSang-Cheol Bae - Hanyang UniversityJorge Sanchez-Guerrero - Toronto Western HospitalJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránAnn E. Clarke - McGill University Health CentreSasha Bernatsky - McGill University Health CentreDaniel J. Wallace - Cedars-Sinai Medical CenterEllen M. Ginzler - SUNY Downstate Health Sciences UniversityDavid A. Isenberg - University College LondonAnisur Rahman - University College LondonJoan T. Merrill - Oklahoma Medical Research FoundationMichelle Petri - Johns Hopkins UniversityPaul R. Fortin - Centre hospitalier universitaire de QuébecDafna D. Gladman - Toronto Western HospitalBarri J. Fessler - University of Alabama at BirminghamGraciela S. Alarcon - University of Alabama at BirminghamIan N. Bruce - Manchester Academic Health Science CentreMary Anne Dooley - University of North Carolina at Chapel HillKristjan Steinsson - Reykjavík UniversityMunther A. Khamashta - St Thomas' HospitalRosalind Ramsey-Goldman - Northwestern UniversitySusan Manzi - University of PittsburghGunnar K. Sturfelt - Lund UniversityOla Nived - Lund UniversityAsad A. Zoma - Hairmyres HospitalRonald F. van Vollenhoven - Karolinska InstitutetManuel Ramos-Casals - Consorci Institut D'Investigacions Biomediques August Pi I SunyerCynthia Aranow - Feinstein Institute for Medical ResearchMeggan Mackay - Feinstein Institute for Medical ResearchGuillermo Ruiz-Irastorza - Hospital de CrucesKenneth C. Kalunian - University of California, San DiegoS. Sam Lim - Emory UniversityMurat Inanc - Istanbul UniversityDiane L. Kamen - Medical University of South CarolinaChristine A. Peschken - University of ManitobaSoren Jacobsen - Copenhagen Univ Hosp, Rigshosp, Copenhagen, DenmarkChris Theriault - Queen Elizabeth II Health Sciences CentreKara Thompson - Queen Elizabeth II Health Sciences CentreVernon Farewell - University of Cambridge
- Publication Details
- Arthritis and rheumatism, v 65(11), pp 2887-2897
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- MOP-86526 / Canadian Institutes of Health Research; Canadian Institutes of Health Research (CIHR) NIHR/Wellcome Trust Clinical Research Facility at Central Manchester Foundation Trust; Wellcome Trust MC_U105261167 / Medical Research Council; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) Department of Education, Universities, and Research of the Basque Government MC_U105261167 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) A1028 / Danish Rheumatism Association A05990 / Novo Nordisk Foundation; Novocure Limited U105261167 / Medical Research Council, UK; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) RR-00046; UL-1RR-025741; K24-AR-02318; P60-AR-48098; AR-43727 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Lupus UK
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000326138200018
- Scopus ID
- 2-s2.0-84886776750
- Other Identifier
- 991021934006204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology