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  3. Central nervous system involvement in systemic lupus erythematosus: Data from the Spanish Society of Rheumatology Lupus Register (RELESSER)

Central nervous system involvement in systemic lupus erythematosus: Data from the Spanish Society of Rheumatology Lupus Register (RELESSER)

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Magro-Checa C
  • Ramiro S
  • Rúa-Figueroa I
  • Jimenez N
  • Del Campo-Pérez V
  • Martinez-Barrio J
  • Galindo-Izquierdo M
  • Calvo-Alén J
  • Uriarte-Isacelaya E
  • Tomero-Muriel E
  • Freire-González M
  • Salgado E
  • Vela P
  • Mena-Vázquez N
  • Olivé A
  • Narváez J
  • Menor-Almagro R
  • Santos-Soler G
  • Hernández-Beriaín JA
  • Manero-Ruiz J
  • Aurrecoechea-Aguinaga E
  • Ibarguengoitia O
  • Montilla-Morales C
  • Bonilla-Hernán G
  • Torrente-Segarra V
  • Salman-Monte T
  • Ros-Vilamajo I
  • García-Villanueva MJ
  • Moriano-Morales C
  • Fito-Manteca C
  • Lozano-Rivas N
  • Bohórquez C
  • Pego-Reigosa JM

Unidades

Abstract

Objectives: To analyze the prevalence, incidence, survival and contribution on mortality of major central nervous system (CNS) involvement in systemic lupus erythematosus (SLE).Methods: Patients fulfilling the SLE 1997 ACR classification criteria from the multicentre, retrospective RELESSER-TRANS (Spanish Society of Rheumatology Lupus Register) were included. Prevalence, incidence and survival rates of major CNS neuropsychiatric (NP)-SLE as a group and the individual NP manifestations cere-brovascular disease (CVD), seizure, psychosis, organic brain syndrome and transverse myelitis were calculated. Furthermore, the contribution of these manifestations on mortality was analysed in Cox regression models adjusted for confounders.Results: A total of 3591 SLE patients were included. Of them, 412 (11.5%) developed a total of 522 major CNS NP-SLE manifestations. 61 patients (12%) with major CNS NP-SLE died. The annual mortality rate for patients with and without ever major CNS NP-SLE was 10.8% vs 3.8%, respectively. Individually, CVD (14%) and organic brain syndrome (15.5%) showed the highest mortality rates. The 10% mortality rate for patients with and without ever major CNS NP-SLE was reached after 12.3 vs 22.8 years, respectively. CVD (9.8 years) and organic brain syndrome (7.1 years) reached the 10% mortality rate earlier than other major CNS NP-SLE manifestations. Major CNS NP-SLE (HR 1.85, 1.29-2.67) and more specifically CVD (HR 2.17, 1.41-3.33) and organic brain syndrome (HR 2.11, 1.19-3.74) accounted as independent prognostic factors for poor survival.Conclusion: The presentation of major CNS NP-SLE during the disease course contributes to a higher mortality, which may differ depending on the individual NP manifestation. CVD and organic brain syndrome are associated with the highest mortality rates.

Copyright © 2022 Elsevier Inc. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
0049-0172, 1532-866X

SEMINARS IN ARTHRITIS AND RHEUMATISM  W B SAUNDERS CO-ELSEVIER INC

Tipo:
Article
Páginas:
152121-152121
PubMed:
36375359

Citas Recibidas en Web of Science: 2

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Keywords

  • Central nervous system; Mortality; NP-SLE; Survival; Systemic lupus erythematosus

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