John G Hanly1, Qiuju Li2, Li Su2, Murray B Urowitz3, Caroline Gordon4, Sang-Cheol Bae5, Juanita Romero-Diaz6, Jorge Sanchez-Guerrero3, Sasha Bernatsky7, Ann E Clarke8, Daniel J Wallace9, David A Isenberg10, Anisur Rahman10, Joan T Merrill11, Paul R Fortin12, Dafna D Gladman3, Ian N Bruce13, Michelle Petri14, Ellen M Ginzler15, M A Dooley16, Kristjan Steinsson17, Rosalind Ramsey-Goldman18, Asad A Zoma19, Susan Manzi20, Ola Nived21, Andreas Jonsen21, Munther A Khamashta22, Graciela S Alarcón23, Elisabet Svenungsson24, Ronald F van Vollenhoven25, Cynthia Aranow26, Meggan Mackay26, Guillermo Ruiz-Irastorza27, Manuel Ramos-Casals28, S Sam Lim29, Murat Inanc30, Kenneth C Kalunian31, Soren Jacobsen32, Christine A Peschken33, Diane L Kamen34, Anca Askanase35, Chris Theriault1, Vernon Farewell2. 1. Queen Elizabeth II Health Sciences Center and Dalhousie University, Halifax, Nova Scotia, Canada. 2. University of Cambridge, Cambridge, UK. 3. Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada. 4. University of Birmingham College of Medical and Dental Sciences, Birmingham, UK. 5. Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. 6. Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico. 7. McGill University, Montreal, Quebec, Canada. 8. University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada. 9. Cedars-Sinai and University of California, Los Angeles School of Medicine. 10. University College London, London, UK. 11. Oklahoma Medical Research Foundation, Oklahoma City. 12. CHU de Québec and Université Laval, Québec City, Québec, Canada. 13. Arthritis Research UK Epidemiology Unit, University of Manchester, NIHR Manchester Musculoskeletal Biomedical Research Centre, and Manchester University NHS Foundation Trust, Manchester, UK. 14. Johns Hopkins University School of Medicine, Baltimore, Maryland. 15. SUNY Downstate Medical Center, Brooklyn, New York. 16. University of North Carolina, Chapel Hill, North Carolina. 17. Landspitali University Hospital, Reykjavík, Iceland. 18. Northwestern University and Feinberg School of Medicine, Chicago, Illinois. 19. Hairmyres Hospital, East Kilbride, UK. 20. Allegheny Health Network, Pittsburgh, Pennsylvania. 21. Lund University, Lund, Sweden. 22. St. Thomas' Hospital and King's College London School of Medicine, London, UK. 23. University of Alabama at Birmingham. 24. Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 25. Amsterdam University Medical Centers, Amsterdam, The Netherlands. 26. Feinstein Institute for Medical Research, Manhasset, New York. 27. Hospital Universitario Cruces and University of the Basque Country, Barakaldo, Spain. 28. Institut d'Investigacions Biomèdiques August Pi i Sunyer and Hospital Clínic de Barcelona, Barcelona, Spain. 29. Emory University School of Medicine, Atlanta, Georgia. 30. Istanbul University, Istanbul, Turkey. 31. University of California San Diego School of Medicine. 32. Rigshospitalet and Copenhagen University Hospital, Copenhagen, Denmark. 33. University of Manitoba, Winnipeg, Manitoba, Canada. 34. Medical University of South Carolina, Charleston. 35. NYU Langone Orthopedic Hospital, New York, New York.
Abstract
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.
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.
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Authors: V Golder; J J Y Ooi; A S Antony; T Ko; S Morton; R Kandane-Rathnayake; E F Morand; A Y Hoi Journal: Lupus Date: 2017-08-01 Impact factor: 2.911
Authors: J G Hanly; M B Urowitz; F Siannis; V Farewell; C Gordon; S C Bae; D Isenberg; M A Dooley; A Clarke; S Bernatsky; D Gladman; P R Fortin; S Manzi; K Steinsson; I N Bruce; E Ginzler; C Aranow; D J Wallace; R Ramsey-Goldman; R van Vollenhoven; G Sturfelt; O Nived; J Sanchez-Guerrero; G S Alarcón; M Petri; M Khamashta; A Zoma; J Font; K Kalunian; J Douglas; Q Qi; K Thompson; J T Merrill Journal: Arthritis Rheum Date: 2008-03
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Authors: D Nikolopoulos; M Kostopoulou; A Pieta; T Karageorgas; D Tseronis; K Chavatza; S Flouda; P Rapsomaniki; A Banos; E Kremasmenou; V Tzavara; P Katsimbri; A Fanouriakis; D T Boumpas Journal: Lupus Date: 2020-02-27 Impact factor: 2.911
Authors: John G Hanly; Caroline Gordon; Sang-Cheol Bae; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Sasha Bernatsky; Ann E Clarke; Daniel J Wallace; David A Isenberg; Anisur Rahman; Joan T Merrill; Paul R Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; Michelle Petri; Ellen M Ginzler; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Andreas Jonsen; Graciela S Alarcón; Ronald F van Vollenhoven; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Diane L Kamen; Anca Askanase; Vernon Farewell Journal: Arthritis Rheumatol Date: 2021-10-29 Impact factor: 15.483
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