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

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 (S...

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Detalles Bibliográficos
Autores: 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, Martínez-Taboada V, 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p14768
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/14768
Access Level:acceso abierto
Palabra clave:Systemic lupus erythematosus
NP-SLE
Central nervous system
Survival
Mortality
Descripción
Sumario: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.

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