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Journal article
Neuropsychiatric Events in Systemic Lupus Erythematosus: Predictors of Occurrence and Resolution in a Longitudinal Analysis of an International Inception Cohort
Arthritis & rheumatology (Hoboken, N.J.), v 73(12), pp 2293-2302
Dec 2021
PMID: 34042329
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To determine predictors of change in neuropsychiatric (NP) event status in a large, prospective, international inception cohort of patients with systemic lupus erythematosus (SLE).
Upon enrollment and annually thereafter, NP events attributed to SLE and non-SLE causes and physician-determined resolution were documented. Factors potentially associated with the onset and resolution of NP events were determined by time-to-event analysis using a multistate modeling structure.
NP events occurred in 955 (52.3%) of 1,827 patients, and 593 (31.0%) of 1,910 unique events were attributed to SLE. For SLE-associated NP (SLE NP) events, multivariate analysis revealed a positive association with male sex (P = 0.028), concurrent non-SLE NP events excluding headache (P < 0.001), active SLE (P = 0.012), and glucocorticoid use (P = 0.008). There was a negative association with Asian race (P = 0.002), postsecondary education (P = 0.001), and treatment with immunosuppressive drugs (P = 0.019) or antimalarial drugs (P = 0.056). For non-SLE NP events excluding headache, there was a positive association with concurrent SLE NP events (P < 0.001) and a negative association with African race (P = 0.012) and Asian race (P < 0.001). NP events attributed to SLE had a higher resolution rate than non-SLE NP events, with the exception of headache, which had comparable resolution rates. For SLE NP events, multivariate analysis revealed that resolution was more common in patients of Asian race (P = 0.006) and for central/focal NP events (P < 0.001). For non-SLE NP events, resolution was more common in patients of African race (P = 0.017) and less common in patients who were older at SLE diagnosis (P < 0.001).
In a large and long-term study of the occurrence and resolution of NP events in SLE, we identified subgroups with better and worse prognosis. The course of NP events differs greatly depending on their nature and attribution.
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Details
- Title
- Neuropsychiatric Events in Systemic Lupus Erythematosus: Predictors of Occurrence and Resolution in a Longitudinal Analysis of an International Inception Cohort
- Creators
- John G Hanly - Queen Elizabeth II Health Sciences CentreCaroline Gordon - University of BirminghamSang-Cheol Bae - Hanyang University Seoul HospitalJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránJorge Sanchez-Guerrero - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránSasha Bernatsky - McGill UniversityAnn E Clarke - University of CalgaryDaniel J Wallace - Cedars-Sinai Medical CenterDavid A Isenberg - University College LondonAnisur Rahman - University College LondonJoan T Merrill - Oklahoma Medical Research FoundationPaul R Fortin - Centre hospitalier de l'Université LavalDafna D Gladman - Toronto Western HospitalMurray B Urowitz - Toronto Western HospitalIan N Bruce - Versus ArthritisMichelle Petri - Johns Hopkins UniversityEllen M Ginzler - SUNY Downstate Health Sciences UniversityM A Dooley - University of North Carolina at Chapel HillRosalind Ramsey-Goldman - Northwestern UniversitySusan Manzi - Allegheny Health NetworkAndreas Jonsen - Lund UniversityGraciela S Alarcón - University of Alabama at BirminghamRonald F van Vollenhoven - Amsterdam University Medical CentersCynthia Aranow - Feinstein Institute for Medical ResearchMeggan Mackay - Feinstein Institute for Medical ResearchGuillermo Ruiz-Irastorza - Hospital de CrucesS Sam Lim - Emory UniversityMurat Inanc - Istanbul UniversityKenneth C Kalunian - University of California, San DiegoSoren Jacobsen - Copenhagen University HospitalChristine A Peschken - University of ManitobaDiane L Kamen - Medical University of South CarolinaAnca Askanase - New York University Langone Orthopedic HospitalVernon Farewell - University of Cambridge
- Publication Details
- Arthritis & rheumatology (Hoboken, N.J.), v 73(12), pp 2293-2302
- Publisher
- Wiley
- Grant note
- P30 AR072579 / NIAMS NIH HHS R01 AR043727 / NIAMS NIH HHS M01 RR000046 / NCRR NIH HHS UL1 TR000150 / NCATS NIH HHS Wellcome Trust UL1 TR001422 / NCATS NIH HHS UL1 RR025741 / NCRR NIH HHS P60 AR048098 / NIAMS NIH HHS P60 AR064464 / NIAMS NIH HHS MOP-88526 / CIHR
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000712288700001
- Scopus ID
- 2-s2.0-85118217441
- Other Identifier
- 991021934008004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology