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Long‐term outcome of early neuropsychiatric events due to active disease in systemic lupus erythematosus
Author(s) -
Wang Michelle,
Gladman Dafna D.,
Ibañez Dominique,
Urowitz Murray B.
Publication year - 2012
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.21624
Subject(s) - term (time) , medicine , systemic disease , disease , outcome (game theory) , systemic lupus erythematosus , physics , economics , mathematical economics , quantum mechanics
Objective Neuropsychiatric (NP) manifestations attributable to active disease affect up to 30% of individuals with systemic lupus erythematosus (SLE). The short‐term impact of NP events includes increased organ damage, fatigue, and mortality, and lower health‐related quality of life. We investigated the impact of NP events attributable to active SLE at presentation on long‐term disease activity, organ damage, and health‐related quality of life. Methods Seventy‐two NP cases and 144 matched controls from the University of Toronto Lupus Cohort, enrolled between 1970 and 2005, were included in the study. NP cases had at least 1 NP event attributable to active SLE at the first clinic visit. Controls did not have NP events at the first clinic visit and were matched to cases on age, sex, disease duration, and decade. Paired case–control analyses were performed on measures of disease activity (Systemic Lupus Erythematosus Disease Activity Index 2000), disease damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), and health‐related quality of life (Short Form 36) at 1 year, 3 years, and 5 years after the first clinic visit. Results NP cases showed greater disease activity than controls at the first clinic visit ( P < 0.0001) and greater cumulative organ damage at 1‐year followup ( P = 0.01). No statistically significant differences were found on 3‐year or 5‐year outcomes. Mean scores showed a decreasing trend of disease activity, increasing organ damage, and persistently low quality of life for both cases and controls. Conclusion This study shows that early NP events due to active SLE are not major contributors to long‐term disease activity, accumulation of damage, or health‐related quality of life. The long‐term prognosis and patterns of disease in SLE patients with early NP events are similar to those of SLE patients without these events.