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dc.contributor.authorHanly, John G
dc.contributor.authorUrowitz, Murray B
dc.contributor.authorSu, Li
dc.contributor.authorGordon, Caroline
dc.contributor.authorBae, Sang-Cheol
dc.contributor.authorSanchez-Guerrero, Jorge
dc.contributor.authorRomero-Diaz, Juanita
dc.contributor.authorWallace, Daniel J
dc.contributor.authorClarke, Ann E
dc.contributor.authorGinzler, Em
dc.contributor.authorMerrill, Joan T
dc.contributor.authorIsenberg, David A
dc.contributor.authorRahman, Anisur
dc.contributor.authorPetri, M
dc.contributor.authorFortin, Paul R
dc.contributor.authorGladman, Dd
dc.contributor.authorBruce, Ian N
dc.contributor.authorSteinsson, Kristjan
dc.contributor.authorDooley, Ma
dc.contributor.authorKhamashta, Munther A
dc.contributor.authorAlarcón, Graciela S
dc.contributor.authorFessler, Barri J
dc.contributor.authorRamsey-Goldman, Rosalind
dc.contributor.authorManzi, Susan
dc.contributor.authorZoma, Asad A
dc.contributor.authorSturfelt, Gunnar K
dc.contributor.authorNived, Ola
dc.contributor.authorAranow, Cynthia
dc.contributor.authorMackay, Meggan
dc.contributor.authorRamos-Casals, Manuel
dc.contributor.authorvan Vollenhoven, Rf
dc.contributor.authorKalunian, Kenneth C
dc.contributor.authorRuiz-Irastorza, Guillermo
dc.contributor.authorLim, Sam
dc.contributor.authorKamen, Diane L
dc.contributor.authorPeschken, Christine A
dc.contributor.authorInanc, Murat
dc.contributor.authorTheriault, Chris
dc.contributor.authorThompson, Kara
dc.contributor.authorFarewell, Vernon
dc.date.accessioned2013-08-16T14:12:18Z
dc.date.available2013-08-16T14:12:18Z
dc.date.issued2012-09
dc.date.submitted2013-08-16
dc.identifier.citationAnn. Rheum. Dis. 2012, 71(9):1502-9en_GB
dc.identifier.issn1468-2060
dc.identifier.pmid22492779
dc.identifier.doi10.1136/annrheumdis-2011-201089
dc.identifier.urihttp://hdl.handle.net/2336/298977
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.
dc.description.abstractThe aim of this study was to describe the frequency, attribution, outcome and predictors of seizures in systemic lupus erythematosus (SLE). The Systemic Lupus International Collaborating Clinics, or SLICC, performed a prospective inception cohort study. Demographic variables, global SLE disease activity (SLE Disease Activity Index 2000), cumulative organ damage (SLICC/American College of Rheumatology Damage Index (SDI)) and neuropsychiatric events were recorded at enrolment and annually. Lupus anticoagulant, anticardiolipin, anti-β(2) glycoprotein-I, antiribosomal P and anti-NR2 glutamate receptor antibodies were measured at enrolment. Physician outcomes of seizures were recorded. Patient outcomes were derived from the SF-36 (36-Item Short Form Health Survey) mental component summary and physical component summary scores. Statistical analyses included Cox and linear regressions. The cohort was 89.4% female with a mean follow-up of 3.5±2.9 years. Of 1631 patients, 75 (4.6%) had ≥1 seizure, the majority around the time of SLE diagnosis. Multivariate analysis indicated a higher risk of seizures with African race/ethnicity (HR (CI): 1.97 (1.07 to 3.63); p=0.03) and lower education status (1.97 (1.21 to 3.19); p<0.01). Higher damage scores (without neuropsychiatric variables) were associated with an increased risk of subsequent seizures (SDI=1:3.93 (1.46 to 10.55); SDI=2 or 3:1.57 (0.32 to 7.65); SDI≥4:7.86 (0.89 to 69.06); p=0.03). There was an association with disease activity but not with autoantibodies. Seizures attributed to SLE frequently resolved (59/78 (76%)) in the absence of antiseizure drugs. There was no significant impact on the mental component summary or physical component summary scores. Antimalarial drugs in the absence of immunosuppressive agents were associated with reduced seizure risk (0.07 (0.01 to 0.66); p=0.03). Seizures occurred close to SLE diagnosis, in patients with African race/ethnicity, lower educational status and cumulative organ damage. Most seizures resolved without a negative impact on health-related quality of life. Antimalarial drugs were associated with a protective effect.
dc.description.sponsorshipCanadian Institutes of Health Research grant MOP-57752 MRC (UK) U105261167 Korea Healthcare Technology R&D Project, Ministry for Health and Welfare, Republic of Korea A080588 Singer Family Fund for Lupus Research National Institutes of Health UL-1RR-025741 K24-AR-02318 P60-AR-48098 Department of Education, Universities and Research of the Basque Governmenten_GB
dc.language.isoenen
dc.relation.urlhttp://dx.doi.org/10.1136/annrheumdis-2011-201089en_GB
dc.rightsArchived with thanks to Annals of the rheumatic diseasesen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshEpilepsyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLupus Erythematosus, Systemicen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshProportional Hazards Modelsen_GB
dc.subject.meshRisk Factorsen_GB
dc.titleSeizure disorders in systemic lupus erythematosus results from an international, prospective, inception cohort study.en
dc.typeArticleen
dc.contributor.departmentDivision of Rheumatology, Nova Scotia Rehabilitation Centre (2nd Floor), 1341 Summer Street, Halifax, Nova Scotia B3H 4K4, Canada.en_GB
dc.identifier.journalAnnals of the rheumatic diseasesen_GB
dc.rights.accessLandspitali Access - LSH-aðganguren
html.description.abstractThe aim of this study was to describe the frequency, attribution, outcome and predictors of seizures in systemic lupus erythematosus (SLE). The Systemic Lupus International Collaborating Clinics, or SLICC, performed a prospective inception cohort study. Demographic variables, global SLE disease activity (SLE Disease Activity Index 2000), cumulative organ damage (SLICC/American College of Rheumatology Damage Index (SDI)) and neuropsychiatric events were recorded at enrolment and annually. Lupus anticoagulant, anticardiolipin, anti-β(2) glycoprotein-I, antiribosomal P and anti-NR2 glutamate receptor antibodies were measured at enrolment. Physician outcomes of seizures were recorded. Patient outcomes were derived from the SF-36 (36-Item Short Form Health Survey) mental component summary and physical component summary scores. Statistical analyses included Cox and linear regressions. The cohort was 89.4% female with a mean follow-up of 3.5±2.9 years. Of 1631 patients, 75 (4.6%) had ≥1 seizure, the majority around the time of SLE diagnosis. Multivariate analysis indicated a higher risk of seizures with African race/ethnicity (HR (CI): 1.97 (1.07 to 3.63); p=0.03) and lower education status (1.97 (1.21 to 3.19); p<0.01). Higher damage scores (without neuropsychiatric variables) were associated with an increased risk of subsequent seizures (SDI=1:3.93 (1.46 to 10.55); SDI=2 or 3:1.57 (0.32 to 7.65); SDI≥4:7.86 (0.89 to 69.06); p=0.03). There was an association with disease activity but not with autoantibodies. Seizures attributed to SLE frequently resolved (59/78 (76%)) in the absence of antiseizure drugs. There was no significant impact on the mental component summary or physical component summary scores. Antimalarial drugs in the absence of immunosuppressive agents were associated with reduced seizure risk (0.07 (0.01 to 0.66); p=0.03). Seizures occurred close to SLE diagnosis, in patients with African race/ethnicity, lower educational status and cumulative organ damage. Most seizures resolved without a negative impact on health-related quality of life. Antimalarial drugs were associated with a protective effect.


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