TY - JOUR
T1 - Peripheral Nervous System Disease in Systemic Lupus Erythematosus
T2 - Results From an International Inception Cohort Study
AU - Hanly, John G
AU - Li, Qiuju
AU - Su, Li
AU - Urowitz, Murray B
AU - Gordon, Caroline
AU - Bae, Sang-Cheol
AU - Romero-Diaz, Juanita
AU - Sanchez-Guerrero, Jorge
AU - Bernatsky, Sasha
AU - Clarke, Ann E
AU - Wallace, Daniel J
AU - Isenberg, David A
AU - Rahman, Anisur
AU - Merrill, Joan T
AU - Fortin, Paul R
AU - Gladman, Dafna D
AU - Bruce, Ian N
AU - Petri, Michelle
AU - Ginzler, Ellen M
AU - Dooley, M A
AU - Steinsson, Kristjan
AU - Ramsey-Goldman, Rosalind
AU - Zoma, Asad A
AU - Manzi, Susan
AU - Nived, Ola
AU - Jonsen, Andreas
AU - Khamashta, Munther A
AU - Alarcón, Graciela S
AU - Svenungsson, Elisabet
AU - van Vollenhoven, Ronald F
AU - Aranow, Cynthia
AU - Mackay, Meggan
AU - Ruiz-Irastorza, Guillermo
AU - Ramos-Casals, Manuel
AU - Lim, S Sam
AU - Inanc, Murat
AU - Kalunian, Kenneth C
AU - Jacobsen, Soren
AU - Peschken, Christine A
AU - Kamen, Diane L
AU - Askanase, Anca
AU - Theriault, Chris
AU - Farewell, Vernon
N1 - © 2019, American College of Rheumatology.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - OBJECTIVE: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients.METHODS: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate.RESULTS: Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy.CONCLUSION: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.
AB - OBJECTIVE: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients.METHODS: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate.RESULTS: Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy.CONCLUSION: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.
UR - http://www.scopus.com/inward/record.url?scp=85075747200&partnerID=8YFLogxK
U2 - 10.1002/art.41070
DO - 10.1002/art.41070
M3 - Journal article
C2 - 31390162
SN - 2326-5191
VL - 72
SP - 67
EP - 77
JO - Arthritis & rheumatology
JF - Arthritis & rheumatology
IS - 1
ER -