Time to neuropsychiatric damage occurrence in LUMINA (LXVI): a multi-ethnic lupus cohort.
The aims of this study were to examine the predictors of time to neuropsychiatric (NP) damage and its impact on mortality in 632 systemic lupus erythematosus African-American, Hispanic and Caucasian LUpus in MInorities: NAture versus Nurture (LUMINA) patients, age >or= 16 years and disease duration <or=5 years at baseline (T0). Time-to-NP damage and its impact on mortality were examined by Cox proportional hazards regressions. A total of 185 (29.3%) patients developed NP damage over a mean (SD) disease duration of 5.6 (3.7) years. After adjusting for NP manifestations present, older age [Hazard ratio (HR) = 1.02; 95% Confidence interval (CI) 1.00-1.04], Caucasian ethnicity (HR = 1.87; 95% CI, 1.22-2.87), disease activity over the disease course (HR = 1.16; 95% CI, 1.12-1.21), diabetes (HR = 3.47; 95% CI, 1.44-8.38) and abnormal illness-related behaviours (HR = 1.05; 95% CI, 1.02-1.08) were associated with a shorter time-to-NP damage. Photosensitivity (HR = 0.65; 95% CI, 0.44-0.95), anaemia (HR = 0.56; 95% CI, 0.31-0.98), Raynaud's phenomenon (HR = 0.49; 95% CI, 0.34-0.72), a medium dose of prednisone (HR = 0.56; 95% CI, 0.35-0.92) and hydroxychloroquine use (HR = 0.58; 95% CI, 0.36-0.93) were associated with a longer time. NP damage did not contribute to mortality. Older age, Caucasian ethnicity, disease activity and abnormal illness-related behaviours are associated with a shorter time-to-NP damage; hydroxychloroquine and a medium dose of prednisone with a longer time.
González
L A
LA
Department of Medicine (Division of Clinical Immunology and Rheumatology), School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Pons-Estel
G J
GJ
Zhang
J
J
Vilá
L M
LM
Reveille
J D
JD
Alarcón
Graciela S
GS
D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000367:Age Factors; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D055809:Illness Behavior; D015994:Incidence; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000208:ethnology* / Q000523:psychology; D020945:Lupus Vasculitis, Central Nervous System / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D013997:Time Factors; D044465:White People / Q000208:ethnology