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Time to neuropsychiatric damage occurrence in LUMINA (LXVI): A multi-ethnic lupus cohort
Lupus, 07/17/09

González LA et al. – Study reports that older age, Caucasian ethnicity, disease activity and abnormal illness-related behaviours are associated with a shorter time-to- neuropsychiatric (NP) damage; hydroxychloroquine and a medium dose of prednisone with a longer time.

Methods

Aim was to examine the predictors of time to NP damage and its impact on mortality in 632 SLE African-American, Hispanic and Caucasian LUpus in MInorities: NAture versus Nurture (LUMINA) pts
Age: ≥16 years; disease duration: ≤5 years at baseline (T0)
Time-to-NP damage and its impact on mortality were examined by Cox proportional hazards regressions

Results

29.3% pts developed NP damage over a mean 5.6 yrs
Factors associated with a shorter time-to-NP damage, after adjusting for NP manifestations present:
- Older age
- Caucasian ethnicity
- Disease activity over the disease course
- Diabetes, and
- Abnormal illness-related behaviours
Photosensitivity, anaemia, Raynaud’s phenomenon, a medium dose of prednisone, and hydroxychloroquine use were associated with a longer time
NP damage did not contribute to mortality

Exclusive Author Commentary
Luis A Gonzalez, 07/20/09

In this multiethnic cohort neuropsychiatric damage was the most common domain of the SDI involved followed by the renal domain (19.6%) with cognitive impairment and/or psychosis in 135 patients the most common NP damage manifestations followed by cerebrovascular events in 45 patients, seizures in 30, cranial/peripheral neuropathy in 22 and transverse myelitis in 3. Another important finding is that in an alternative multivariable model in which NP manfiestations were excluded, aPL antibodies were found to predispose to the ocurrence of NP damage.

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