Everyday cognitive failure in sarcoidosis: the prevalence and the effect of anti-TNF-alpha treatment.
BACKGROUND
Cognitive symptoms, such as concentration problems, are frequently recorded by sarcoidosis patients.


OBJECTIVE
The aim of this study was to assess the prevalence of perceived everyday cognitive failure in sarcoidosis patients and healthy controls. Furthermore, the effect of treatment on cognitive functioning was examined.


METHODS
The study included 343 sarcoidosis patients (44.6% females; age 49.3 +/- 11.0 years). They completed the Cognitive Failure Questionnaire (CFQ) and Fatigue Assessment Scale (FAS) at baseline and the 6-month follow-up to evaluate the effect of treatment on cognitive functioning. The control group consisted of 343 age- and sex-matched healthy controls.


RESULTS
The mean CFQ score was significantly higher in sarcoidosis patients (37.3 +/- 16.1) compared with the controls (31.3 +/- 10.1; p < 0.0001).A high CFQ sore (> or =43) was found in 35.0% of the patients and only 14.3% of the controls. No relation with disease severity and duration, or disease location was found. The proportion of patients receiving treatment did not differ among the groups with high and normal CFQ score. At the 6-month follow-up, only patients recently treated with anti-TNF-alpha therapy (n = 42) demonstrated a significant improvement in the CFQ score (Delta -7.07 +/- 7.23) compared with the untreated patients (Delta -0.08 +/- 9.35) and patients treated with prednisone with or without methotrexate (Delta 1.67 +/- 9.22; p < 0.0001). After adjustment for the concomitant decrease in fatigue, the effect of anti-TNF-alpha therapy remained high and significant.


CONCLUSIONS
Subjective cognitive failure is a substantial problem in sarcoidosis patients regardless of disease severity. Anti-TNF-alpha therapy had a positive effect on cognition, fatigue and other symptoms of sarcoidosis.
Elfferich
Marjon D
MD
Department of Physical Therapy, ild care center,Maastricht University Medical Center, Maastricht, The Netherlands.
Nelemans
Patty J
PJ
Ponds
Rudolf W
RW
De Vries
Jolanda
J
Wijnen
Petal A
PA
Drent
Marjolein
M
D000328:Adult; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016022:Case-Control Studies; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha