Risk factors identified for SLE neuropsychiatric events
MedWire News: Italian researchers have identified risk factors for the development of neuropsychiatric (NP) events in patients with systemic lupus erythematosus (SLE), some of which may be modifiable.
"If a risk profile is prospectively clearly defined and proven, it might translate into clinical and speculative information about the development of new preventive strategies for patients classified at higher risk of NP events (eg, better control of risk factors and intensive follow-up) and properly designed studies on the potential effect of specific drugs (eg, statins) in preventing NPSLE," write Marcello Govoni (University of Ferrara) and co-authors.
The team compared medical records for 312 SLE patients with a total of 469 NP events with those of 633 SLE patients without any NP manifestation. NP events included headache (26.1%), cerebrovascular events, such as stroke or transient ischemic attack (22.7%), mood disorders (8.9%), seizure (14.4%), and cognitive dysfunction (9.5%).
Analysis showed that patients with NP events had on average significantly more generic or SLE-specific risk factors for NP events than controls (4.52 vs 3.73 events).
Specifically, patients with NP events were significantly more likely than those without to have antiphospholipid syndrome (APS), antiphospholipid antibodies (aPL), anticardiolipin antibodies (aCL), lupus anticoagulant, and anti-beta-2-glycoprotein-1 antibodies.
Subtypes and individual NP events were each associated with multiple risk factors, such as accumulated glucocorticosterod use or a history of psychiatric disorders, and modifiable risk factors such as hypertension, smoking, and dyslipidemia.
"A potential role played by certain modifiable cardiovascular generic risk factors, such as hypertension and carotid vasculopathy in [cerebrovascular accident], or hypertension and dyslipidemia in cognitive impairment, suggests a more careful preventive approach to optimize the management of NPSLE," Govoni et al write in the journal Rheumatology.
"For the future, the study of risk factors associated with the time to develop an NP event might be even more informative from a clinical point of view."
By Lynda Williams