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Prospective study of neuropsychiatric events in systemic lupus erythematosus
Journal of Rheumatology, 07/02/09

Hanly JG et al. – The association of lower health-related quality of life (HRQOL) with neuropsychiatric (NP) events over time, independent of progression in cumulative organ damage, emphasizes the persistent negative effect of NP events for pts with systemic lupus erythematosus (SLE).

Methods

Prospective study of NP events and their association with HRQOL over time in SLE pts
Observational cohort study from single academic center for NP events and their attribution at enrollment and at annual assessments for up to 7 yrs
NP events characterized by American College of Rheumatology case definitions
Other variables: global SLE disease activity and cumulative organ damage
Outcomes of NP events recorded and self-report HRQOL measured by mental (MCS) and physical (PCS) component summary scores of Medical Outcomes Study Short Form-36

Results

Of 209 pts: 88% female; 92% Caucasian, mean (SD) age 43.7 (13.8) yrs
Follow-up for 175/209 (84%) pts
Over mean follow-up of 3.6 (2.5) yrs, 299 NP events in 132/209 (63%) pts
NP events attributed to SLE: 31% in 54 pts
On multivariate analysis, lower MCS scores in pts with NP events vs those without events regardless of attribution
Group means for PCS scores significantly lower in pts with NP events regardless of attribution
No association between HRQOL and cumulative organ damage nor between NP events and organ damage progression

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