Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

John G. Hanly; Qiuju Li; Li Su; Murray B. Urowitz; Caroline Gordon; Sang Cheol Bae; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Sasha Bernatsky; Ann E. Clarke; Daniel J. Wallace; David A. Isenberg; Anisur Rahman; Joan T. Merrill; Paul R. Fortin; Dafna D. Gladman; Ian N. Bruce; Michelle Petri; Ellen M. Ginzler; M. A. Dooley; Kristjan Steinsson; Rosalind Ramsey-Goldman; Asad A. Zoma; Susan Manzi; Ola Nived; Andreas Jonsen; Munther A. Khamashta; Graciela S. Alarcón; Elisabet Svenungsson; Ronald F. van Vollenhoven; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; Manuel Ramos-Casals; S. Sam Lim; Murat Inanc; Kenneth C. Kalunian; Soren Jacobsen; Christine A. Peschken; Diane L. Kamen; Anca Askanase; Chris Theriault; Vernon Farewell

doi:10.1002/art.41070

Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

John G. Hanly
, Qiuju Li
, Li Su
, Murray B. Urowitz
, Caroline Gordon
, Sang Cheol Bae
, Juanita Romero-Diaz
, Jorge Sanchez-Guerrero
, Sasha Bernatsky
, Ann E. Clarke
, Daniel J. Wallace
, David A. Isenberg
, Anisur Rahman
, Joan T. Merrill
, Paul R. Fortin
, Dafna D. Gladman
, Ian N. Bruce
, Michelle Petri
, Ellen M. Ginzler
, M. A. Dooley

Kristjan Steinsson, Rosalind Ramsey-Goldman, Asad A. Zoma, Susan Manzi, Ola Nived, Andreas Jonsen, Munther A. Khamashta, Graciela S. Alarcón, Elisabet Svenungsson, Ronald F. van Vollenhoven, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz-Irastorza, Manuel Ramos-Casals, S. Sam Lim, Murat Inanc, Kenneth C. Kalunian, Soren Jacobsen, Christine A. Peschken, Diane L. Kamen, Anca Askanase, Chris Theriault, Vernon Farewell

SUNY Downstate Health Sciences University

QEII Health Sciences Centre
University of Cambridge
University of Toronto
University of Birmingham
Hanyang University
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
McGill University
University of Calgary
University of California at Los Angeles
University College London
Oklahoma Medical Research Foundation
CHU de Québec-Université Laval
University of Manchester
Johns Hopkins University
University of North Carolina at Chapel Hill
Landspitali University Hospital
Northwestern University
NHS Lanarkshire
West Penn Allegheny Health System
Lund University
St Thomas’ Hospital
University of Alabama at Birmingham
Karolinska Institutet
Academic Medical Centre University of Amsterdam
Northwell Health System
University of the Basque Country
August Pi i Sunyer Biomedical Research Institute
Emory University
Istanbul University
University of California at San Diego
University of Copenhagen
University of Manitoba
Medical University of South Carolina
New York University

Research output: Contribution to journal › Article › peer-review

59 Scopus citations

Abstract

Objective: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients. Methods: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate. Results: Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy. Conclusion: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.

Original language	English
Pages (from-to)	67-77
Number of pages	11
Journal	Arthritis and Rheumatology
Volume	72
Issue number	1
DOIs	https://doi.org/10.1002/art.41070
State	Published - Jan 1 2020

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Hanly, J. G., Li, Q., Su, L., Urowitz, M. B., Gordon, C., Bae, S. C., Romero-Diaz, J., Sanchez-Guerrero, J., Bernatsky, S., Clarke, A. E., Wallace, D. J., Isenberg, D. A., Rahman, A., Merrill, J. T., Fortin, P. R., Gladman, D. D., Bruce, I. N., Petri, M., Ginzler, E. M., ... Farewell, V. (2020). Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study. Arthritis and Rheumatology, 72(1), 67-77. https://doi.org/10.1002/art.41070

@article{7853e128dc5c47ce930d51a3254bcd43,

title = "Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study",

abstract = "Objective: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients. Methods: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate. Results: Of 1,827 SLE patients, 88.8\% were female, and 48.8\% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6\%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0\%]), mononeuropathy (44 of 161 [27.3\%]), and cranial neuropathy (39 of 161 [24.2\%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy. Conclusion: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.",

author = "Hanly, \{John G.\} and Qiuju Li and Li Su and Urowitz, \{Murray B.\} and Caroline Gordon and Bae, \{Sang Cheol\} and Juanita Romero-Diaz and Jorge Sanchez-Guerrero and Sasha Bernatsky and Clarke, \{Ann E.\} and Wallace, \{Daniel J.\} and Isenberg, \{David A.\} and Anisur Rahman and Merrill, \{Joan T.\} and Fortin, \{Paul R.\} and Gladman, \{Dafna D.\} and Bruce, \{Ian N.\} and Michelle Petri and Ginzler, \{Ellen M.\} and Dooley, \{M. A.\} and Kristjan Steinsson and Rosalind Ramsey-Goldman and Zoma, \{Asad A.\} and Susan Manzi and Ola Nived and Andreas Jonsen and Khamashta, \{Munther A.\} and Alarc{\'o}n, \{Graciela S.\} and Elisabet Svenungsson and \{van Vollenhoven\}, \{Ronald F.\} and Cynthia Aranow and Meggan Mackay and Guillermo Ruiz-Irastorza and Manuel Ramos-Casals and Lim, \{S. Sam\} and Murat Inanc and Kalunian, \{Kenneth C.\} and Soren Jacobsen and Peschken, \{Christine A.\} and Kamen, \{Diane L.\} and Anca Askanase and Chris Theriault and Vernon Farewell",

note = "Publisher Copyright: {\textcopyright} 2019, American College of Rheumatology",

year = "2020",

month = jan,

day = "1",

doi = "10.1002/art.41070",

language = "English",

volume = "72",

pages = "67--77",

journal = "Arthritis and Rheumatology",

issn = "2326-5191",

publisher = "John Wiley and Sons Ltd",

number = "1",

}

Hanly, JG, Li, Q, Su, L, Urowitz, MB, Gordon, C, Bae, SC, Romero-Diaz, J, Sanchez-Guerrero, J, Bernatsky, S, Clarke, AE, Wallace, DJ, Isenberg, DA, Rahman, A, Merrill, JT, Fortin, PR, Gladman, DD, Bruce, IN, Petri, M, Ginzler, EM, Dooley, MA, Steinsson, K, Ramsey-Goldman, R, Zoma, AA, Manzi, S, Nived, O, Jonsen, A, Khamashta, MA, Alarcón, GS, Svenungsson, E, van Vollenhoven, RF, Aranow, C, Mackay, M, Ruiz-Irastorza, G, Ramos-Casals, M, Lim, SS, Inanc, M, Kalunian, KC, Jacobsen, S, Peschken, CA, Kamen, DL, Askanase, A, Theriault, C & Farewell, V 2020, 'Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study', Arthritis and Rheumatology, vol. 72, no. 1, pp. 67-77. https://doi.org/10.1002/art.41070

TY - JOUR

T1 - Peripheral Nervous System Disease in Systemic Lupus Erythematosus

T2 - Results From an International Inception Cohort Study

AU - Hanly, John G.

AU - Li, Qiuju

AU - Su, Li

AU - Urowitz, Murray B.

AU - Gordon, Caroline

AU - Bae, Sang Cheol

AU - Romero-Diaz, Juanita

AU - Sanchez-Guerrero, Jorge

AU - Bernatsky, Sasha

AU - Clarke, Ann E.

AU - Wallace, Daniel J.

AU - Isenberg, David A.

AU - Rahman, Anisur

AU - Merrill, Joan T.

AU - Fortin, Paul R.

AU - Gladman, Dafna D.

AU - Bruce, Ian N.

AU - Petri, Michelle

AU - Ginzler, Ellen M.

AU - Dooley, M. A.

AU - Steinsson, Kristjan

AU - Ramsey-Goldman, Rosalind

AU - Zoma, Asad A.

AU - Manzi, Susan

AU - Nived, Ola

AU - Jonsen, Andreas

AU - Khamashta, Munther A.

AU - Alarcón, Graciela S.

AU - Svenungsson, Elisabet

AU - van Vollenhoven, Ronald F.

AU - Aranow, Cynthia

AU - Mackay, Meggan

AU - Ruiz-Irastorza, Guillermo

AU - Ramos-Casals, Manuel

AU - Lim, S. Sam

AU - Inanc, Murat

AU - Kalunian, Kenneth C.

AU - Jacobsen, Soren

AU - Peschken, Christine A.

AU - Kamen, Diane L.

AU - Askanase, Anca

AU - Theriault, Chris

AU - Farewell, Vernon

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Objective: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients. Methods: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate. Results: Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy. Conclusion: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.

AB - Objective: To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients. Methods: Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate. Results: Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy. Conclusion: PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.

UR - https://www.scopus.com/pages/publications/85075747200

U2 - 10.1002/art.41070

DO - 10.1002/art.41070

M3 - Article

C2 - 31390162

SN - 2326-5191

VL - 72

SP - 67

EP - 77

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

IS - 1

ER -

Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

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