Factors associated with neuropsychiatric involvement in Latin American patients with systemic lupus erythematosus
Journal
Lupus
ISSN
0961-2033
1477-0962
Date Issued
2021
Author(s)
Leonor A Barile-Fabris
Hilda Fragoso-Loyo
Daniel Wojdyla
Rosana Quintana
Guillermo J Pons-Estel
Luis J Catoggio
Mercedes A García
Verónica Saurit
Cristina Drenkard
Eloisa Bonfa
Eduardo F Borba
Emilia Sato
Joao C Tavares Brenol
Fernando Cavalcanti
Nilzio A Da Silva
Lilian T Lavras Costallat
Marlene Guibert Toledano
Loreto Massardo
Mario H Cardiel
Mary Carmen Amigo
Ignacio García De La Torre
Luis H Silveira
Eduardo M Acevedo Vásquez
Rosa Chacón-Diaz
María H Esteva-Spinetti
Graciela S Alarcón
Bernardo A Pons-Estel
Type
Resource Types::text::journal::journal article
Abstract
<jats:sec><jats:title>Introduction</jats:title><jats:p> Factors related to presentation of neuropsychiatric (NP) SLE manifestations, early in the course of the disease, and during follow up have not been clearly established. </jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p> To identify disease and non-disease related factors associated with NP manifestations in early SLE. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> We included 1193 patients from the GLADEL inception cohort free of NP involvement at cohort entry. We evaluated the association of demographic, clinical and laboratory data with NP involvement during follow-up. </jats:p></jats:sec><jats:sec><jats:title>Statistical methods</jats:title><jats:p> Independent factors associated with NP involvement were identified using a multivariable Cox regression model. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Factors independently associated with NP manifestations were: mestizo ethnicity (HR 1.701, 95% CI 1.282–2.258, p = 0.0002), myalgias/myositis (HR 1.832, 95% CI 1.335–2.515, p = 0.0002), pneumonitis (HR 2.476, 95% CI 1.085–5.648, p = 0.0312), shrinking lung (HR 2.428, 95% CI 1.074–5.493, p = 0.0331) and hemolytic anemia (HR 1.629, 95% CI 1.130–2.347, p = 0.0089). Longer disease duration at cohort entry (13 to 24 months) was associated with a lower risk of developing NP manifestations (HR 0.642, 95% CI 0.441–0.934, p = 0.0206). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Patients with myalgias/myositis, pneumonitis, shrinking lung and hemolytic anemia are at higher risk of NP involvement, whereas longer disease duration at cohort entry is associated with a lower risk of developing NP involvement. </jats:p></jats:sec>
Subjects
systemic lupus erythematosus
;
neuropsychiatric manifestations
;
prognostic factors
;
anemia, hemolytic
;
female
;
humans
;
latin america
;
lung diseases
;
lupus erythematosus, systemic
;
lupus vasculitis, central nervous system
;
male
;
muscular diseases
;
prevalence
;
time factors
;
antimalarial agent
;
chloroquine
;
cyclophosphamide
;
glucocorticoid
;
hydroxychloroquine
;
methylprednisolone
;
prednisolone
;
article
;
caucasian
;
cohort analysis
;
disease activity
;
disease duration
;
ethnicity
;
female
;
follow up
;
hemolytic anemia
;
human
;
major clinical study
;
male
;
mental disease
;
mestizo
;
myalgia
;
myositis
;
pneumonia
;
social status
;
systemic lupus erythematosus
;
brain vasculitis
;
complication
;
hemolytic anemia
;
lung disease
;
muscle disease
;
prevalence
;
south and central america
;
systemic lupus erythematosus
;
time factor