Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: An international inception cohort study

J. G. Hanly, M. B. Urowitz, J. Sanchez-Guerrero, S. C. Bae, C. Gordon, D. J. Wallace, D. Isenberg, G. S. Alarcón, A. Clarke, S. Bernatsky, J. T. Merrill, Michelle Petri, M. A. Dooley, D. Gladman, P. R. Fortin, K. Steinsson, I. Bruce, S. Manzi, M. Khamashta, A. ZomaC. Aranow, E. Ginzler, R. Van Vollenhoven, J. Font, G. Sturfelt, O. Nived, R. Ramsey-Goldman, K. Kalunian, J. Douglas, K. Thompson, V. Farewell

Research output: Contribution to journalArticle

Abstract

Objective. To describe the prevalence, characteristics, attribution, and clinical significance of neuropsychiatric (NP) events in an international inception cohort of systemic lupus erythematosus (SLE) patients. Methods. The study was conducted by the Systemic Lupus International Collaborating Clinics (SLICC). Patients were enrolled within 15 months of fulfilling the American College of Rheumatology (ACR) SLE classification criteria. All NP events within a predefined enrollment window were identified using the ACR case definitions of 19 NP syndromes. Decision rules were derived to determine the proportion of NP disease attributable to SLE. Clinical significance was determined using the Short Form 36 (SF-36) Health Survey and the SLICC/ACR Damage Index (SDI). Results. A total of 572 patients (88% female) were recruited, with a mean ± D age of 35 ± 4 years. The mean ± D disease duration was 5.2 ± 4.2 months. Within the enrollment window, 158 of 572 patients (28%) had at least 1 NP event. In total, there were 242 NP events that encompassed 15 of 19 NP syndromes. The proportion of NP events attributed to SLE varied from 19% to 38% using alternate attribution models and occurred in 6.1-11.7% of patients. Those with NP events, regardless of attribution, had lower scores on the SF-36 and higher SDI scores compared with patients with no NP events. Conclusion. Twenty-eight percent of SLE patients experienced at least 1 NP event around the time of diagnosis of SLE, of which only a minority were attributed to SLE. Regardless of attribution, the occurrence of NP events was associated with reduced quality of life and increased organ damage.

Original languageEnglish (US)
Pages (from-to)265-273
Number of pages9
JournalArthritis and Rheumatism
Volume56
Issue number1
DOIs
StatePublished - Jan 2007

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Systemic Lupus Erythematosus
Cohort Studies
Rheumatology
Health Surveys
Quality of Life

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

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Hanly, J. G., Urowitz, M. B., Sanchez-Guerrero, J., Bae, S. C., Gordon, C., Wallace, D. J., ... Farewell, V. (2007). Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: An international inception cohort study. Arthritis and Rheumatism, 56(1), 265-273. https://doi.org/10.1002/art.22305

Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus : An international inception cohort study. / Hanly, J. G.; Urowitz, M. B.; Sanchez-Guerrero, J.; Bae, S. C.; Gordon, C.; Wallace, D. J.; Isenberg, D.; Alarcón, G. S.; Clarke, A.; Bernatsky, S.; Merrill, J. T.; Petri, Michelle; Dooley, M. A.; Gladman, D.; Fortin, P. R.; Steinsson, K.; Bruce, I.; Manzi, S.; Khamashta, M.; Zoma, A.; Aranow, C.; Ginzler, E.; Van Vollenhoven, R.; Font, J.; Sturfelt, G.; Nived, O.; Ramsey-Goldman, R.; Kalunian, K.; Douglas, J.; Thompson, K.; Farewell, V.

In: Arthritis and Rheumatism, Vol. 56, No. 1, 01.2007, p. 265-273.

Research output: Contribution to journalArticle

Hanly, JG, Urowitz, MB, Sanchez-Guerrero, J, Bae, SC, Gordon, C, Wallace, DJ, Isenberg, D, Alarcón, GS, Clarke, A, Bernatsky, S, Merrill, JT, Petri, M, Dooley, MA, Gladman, D, Fortin, PR, Steinsson, K, Bruce, I, Manzi, S, Khamashta, M, Zoma, A, Aranow, C, Ginzler, E, Van Vollenhoven, R, Font, J, Sturfelt, G, Nived, O, Ramsey-Goldman, R, Kalunian, K, Douglas, J, Thompson, K & Farewell, V 2007, 'Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: An international inception cohort study', Arthritis and Rheumatism, vol. 56, no. 1, pp. 265-273. https://doi.org/10.1002/art.22305
Hanly, J. G. ; Urowitz, M. B. ; Sanchez-Guerrero, J. ; Bae, S. C. ; Gordon, C. ; Wallace, D. J. ; Isenberg, D. ; Alarcón, G. S. ; Clarke, A. ; Bernatsky, S. ; Merrill, J. T. ; Petri, Michelle ; Dooley, M. A. ; Gladman, D. ; Fortin, P. R. ; Steinsson, K. ; Bruce, I. ; Manzi, S. ; Khamashta, M. ; Zoma, A. ; Aranow, C. ; Ginzler, E. ; Van Vollenhoven, R. ; Font, J. ; Sturfelt, G. ; Nived, O. ; Ramsey-Goldman, R. ; Kalunian, K. ; Douglas, J. ; Thompson, K. ; Farewell, V. / Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus : An international inception cohort study. In: Arthritis and Rheumatism. 2007 ; Vol. 56, No. 1. pp. 265-273.
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abstract = "Objective. To describe the prevalence, characteristics, attribution, and clinical significance of neuropsychiatric (NP) events in an international inception cohort of systemic lupus erythematosus (SLE) patients. Methods. The study was conducted by the Systemic Lupus International Collaborating Clinics (SLICC). Patients were enrolled within 15 months of fulfilling the American College of Rheumatology (ACR) SLE classification criteria. All NP events within a predefined enrollment window were identified using the ACR case definitions of 19 NP syndromes. Decision rules were derived to determine the proportion of NP disease attributable to SLE. Clinical significance was determined using the Short Form 36 (SF-36) Health Survey and the SLICC/ACR Damage Index (SDI). Results. A total of 572 patients (88{\%} female) were recruited, with a mean ± D age of 35 ± 4 years. The mean ± D disease duration was 5.2 ± 4.2 months. Within the enrollment window, 158 of 572 patients (28{\%}) had at least 1 NP event. In total, there were 242 NP events that encompassed 15 of 19 NP syndromes. The proportion of NP events attributed to SLE varied from 19{\%} to 38{\%} using alternate attribution models and occurred in 6.1-11.7{\%} of patients. Those with NP events, regardless of attribution, had lower scores on the SF-36 and higher SDI scores compared with patients with no NP events. Conclusion. Twenty-eight percent of SLE patients experienced at least 1 NP event around the time of diagnosis of SLE, of which only a minority were attributed to SLE. Regardless of attribution, the occurrence of NP events was associated with reduced quality of life and increased organ damage.",
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T1 - Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus

T2 - An international inception cohort study

AU - Hanly, J. G.

AU - Urowitz, M. B.

AU - Sanchez-Guerrero, J.

AU - Bae, S. C.

AU - Gordon, C.

AU - Wallace, D. J.

AU - Isenberg, D.

AU - Alarcón, G. S.

AU - Clarke, A.

AU - Bernatsky, S.

AU - Merrill, J. T.

AU - Petri, Michelle

AU - Dooley, M. A.

AU - Gladman, D.

AU - Fortin, P. R.

AU - Steinsson, K.

AU - Bruce, I.

AU - Manzi, S.

AU - Khamashta, M.

AU - Zoma, A.

AU - Aranow, C.

AU - Ginzler, E.

AU - Van Vollenhoven, R.

AU - Font, J.

AU - Sturfelt, G.

AU - Nived, O.

AU - Ramsey-Goldman, R.

AU - Kalunian, K.

AU - Douglas, J.

AU - Thompson, K.

AU - Farewell, V.

PY - 2007/1

Y1 - 2007/1

N2 - Objective. To describe the prevalence, characteristics, attribution, and clinical significance of neuropsychiatric (NP) events in an international inception cohort of systemic lupus erythematosus (SLE) patients. Methods. The study was conducted by the Systemic Lupus International Collaborating Clinics (SLICC). Patients were enrolled within 15 months of fulfilling the American College of Rheumatology (ACR) SLE classification criteria. All NP events within a predefined enrollment window were identified using the ACR case definitions of 19 NP syndromes. Decision rules were derived to determine the proportion of NP disease attributable to SLE. Clinical significance was determined using the Short Form 36 (SF-36) Health Survey and the SLICC/ACR Damage Index (SDI). Results. A total of 572 patients (88% female) were recruited, with a mean ± D age of 35 ± 4 years. The mean ± D disease duration was 5.2 ± 4.2 months. Within the enrollment window, 158 of 572 patients (28%) had at least 1 NP event. In total, there were 242 NP events that encompassed 15 of 19 NP syndromes. The proportion of NP events attributed to SLE varied from 19% to 38% using alternate attribution models and occurred in 6.1-11.7% of patients. Those with NP events, regardless of attribution, had lower scores on the SF-36 and higher SDI scores compared with patients with no NP events. Conclusion. Twenty-eight percent of SLE patients experienced at least 1 NP event around the time of diagnosis of SLE, of which only a minority were attributed to SLE. Regardless of attribution, the occurrence of NP events was associated with reduced quality of life and increased organ damage.

AB - Objective. To describe the prevalence, characteristics, attribution, and clinical significance of neuropsychiatric (NP) events in an international inception cohort of systemic lupus erythematosus (SLE) patients. Methods. The study was conducted by the Systemic Lupus International Collaborating Clinics (SLICC). Patients were enrolled within 15 months of fulfilling the American College of Rheumatology (ACR) SLE classification criteria. All NP events within a predefined enrollment window were identified using the ACR case definitions of 19 NP syndromes. Decision rules were derived to determine the proportion of NP disease attributable to SLE. Clinical significance was determined using the Short Form 36 (SF-36) Health Survey and the SLICC/ACR Damage Index (SDI). Results. A total of 572 patients (88% female) were recruited, with a mean ± D age of 35 ± 4 years. The mean ± D disease duration was 5.2 ± 4.2 months. Within the enrollment window, 158 of 572 patients (28%) had at least 1 NP event. In total, there were 242 NP events that encompassed 15 of 19 NP syndromes. The proportion of NP events attributed to SLE varied from 19% to 38% using alternate attribution models and occurred in 6.1-11.7% of patients. Those with NP events, regardless of attribution, had lower scores on the SF-36 and higher SDI scores compared with patients with no NP events. Conclusion. Twenty-eight percent of SLE patients experienced at least 1 NP event around the time of diagnosis of SLE, of which only a minority were attributed to SLE. Regardless of attribution, the occurrence of NP events was associated with reduced quality of life and increased organ damage.

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