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Neuropsychiatric ev...
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Hanly, John G.Dalhousie University
(author)
Neuropsychiatric events in systemic lupus erythematosus : A longitudinal analysis of outcomes in an international inception cohort using a multistate model approach
- Article/chapterEnglish2020
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LIBRIS-ID:oai:lup.lub.lu.se:34f6bb79-8da8-4cd8-b260-a7d48bce09c3
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https://lup.lub.lu.se/record/34f6bb79-8da8-4cd8-b260-a7d48bce09c3URI
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https://doi.org/10.1136/annrheumdis-2019-216150DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:143200659URI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Objectives: Using a reversible multistate model, we prospectively examined neuropsychiatric (NP) events for attribution, outcome and association with health-related quality of life (HRQoL), in an international, inception cohort of systemic lupus erythematosus (SLE) patients. Methods: Annual assessments for 19 NP events attributed to SLE and non-SLE causes, physician determination of outcome and patient HRQoL (short-form (SF)-36 scores) were measured. Time-to-event analysis and multistate modelling examined the onset, recurrence and transition between NP states. Results: NP events occurred in 955/1827 (52.3%) patients and 592/1910 (31.0%) unique events were attributed to SLE. In the first 2 years of follow-up the relative risk (95% CI) for SLE NP events was 6.16 (4.96, 7.66) and non-SLE events was 4.66 (4.01, 5.43) compared with thereafter. Patients without SLE NP events at initial assessment had a 74% probability of being event free at 10 years. For non-SLE NP events the estimate was 48%. The majority of NP events resolved over 10 years but mortality was higher in patients with NP events attributed to SLE (16%) versus patients with no NPSLE events (6%) while the rate was comparable in patients with non-SLE NP events (7%) compared with patients with no non-SLE events (6%). Patients with NP events had lower SF-36 summary scores compared with those without NP events and resolved NP states (p<0.001). Conclusions: NP events occur most frequently around the diagnosis of SLE. Although the majority of events resolve they are associated with reduced HRQoL and excess mortality. Multistate modelling is well suited for the assessment of NP events in SLE.
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Urowitz, Murray B.University of Toronto
(author)
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Gordon, CarolineUniversity of Birmingham
(author)
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Bae, Sang CheolHanyang University
(author)
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Romero-Diaz, JuanitaInstituto Nacional de Ciencias Médicas y Nutrición
(author)
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Sanchez-Guerrero, JorgeToronto Western Hospital,University of Toronto
(author)
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Bernatsky, SashaMcGill University
(author)
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Clarke, Ann E.University of Calgary
(author)
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Wallace, Daniel J.University of California, Los Angeles
(author)
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Isenberg, David A.University College London
(author)
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Rahman, AnisurUniversity College London
(author)
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Merrill, Joan T.Oklahoma Medical Research Foundation
(author)
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Fortin, Paul R.Laval University
(author)
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Gladman, Dafna D.University of Toronto
(author)
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Bruce, Ian N.Manchester Academic Health Science Centre,University of Manchester
(author)
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Petri, MichelleJohns Hopkins University School of Medicine
(author)
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Ginzler, Ellen M.SUNY Downstate Health Sciences University
(author)
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Dooley, Mary AnneUniversity of North Carolina
(author)
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Ramsey-Goldman, RosalindNorthwestern University Feinberg School of Medicine
(author)
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Manzi, SusanAllegheny Health Network
(author)
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Jönsen, AndreasLund University,Lunds universitet,Lund SLE Research Group,Forskargrupper vid Lunds universitet,Lund University Research Groups(Swepub:lu)reum-ajo
(author)
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Alarcón, Graciela S.University of Alabama
(author)
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Van Vollenhoven, Ronald F.Karolinska Institutet
(author)
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Aranow, CynthiaFeinstein Institute for Medical Research
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MacKay, MegganFeinstein Institute for Medical Research
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Ruiz-Irastorza, GuillermoUniversity of the Basque Country
(author)
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Lim, SamEmory University
(author)
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Inanc, MuratIstanbul University
(author)
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Kalunian, Kenneth C.University of California, San Diego
(author)
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Jacobsen, SørenCopenhagen University Hospital
(author)
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Peschken, Christine A.University of Manitoba
(author)
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Kamen, Diane L.Medical University of South Carolina
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Askanase, AncaNYU Hospital for Joint Diseases
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Farewell, VernonUniversity of Cambridge
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Dalhousie UniversityUniversity of Toronto
(creator_code:org_t)
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In:Annals of the Rheumatic Diseases: BMJ79:3, s. 356-3620003-49671468-2060
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Hanly, John G.
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Urowitz, Murray ...
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Gordon, Caroline
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Bae, Sang Cheol
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Romero-Diaz, Jua ...
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Sanchez-Guerrero ...
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Bernatsky, Sasha
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Clarke, Ann E.
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Wallace, Daniel ...
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Isenberg, David ...
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Rahman, Anisur
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Merrill, Joan T.
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Fortin, Paul R.
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Gladman, Dafna D ...
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Bruce, Ian N.
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Petri, Michelle
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Ginzler, Ellen M ...
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Dooley, Mary Ann ...
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Ramsey-Goldman, ...
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Manzi, Susan
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Jönsen, Andreas
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Alarcón, Graciel ...
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Van Vollenhoven, ...
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Aranow, Cynthia
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MacKay, Meggan
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Ruiz-Irastorza, ...
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Lim, Sam
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Inanc, Murat
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Kalunian, Kennet ...
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Jacobsen, Søren
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Peschken, Christ ...
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Kamen, Diane L.
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Askanase, Anca
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Farewell, Vernon
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Lund University
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Karolinska Institutet