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Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus

Hanly, J. G.; Urowitz, M. B.; Su, L.; Bae, S-C; Gordon, C.; Clarke, A.; Bernatsky, S.; Vasudevan, A.; Isenberg, D. and Rahman, A., et al. (2011) In Annals of the Rheumatic Diseases 70(10). p.1726-1732
Abstract
Objective Neuropsychiatric events occur unpredictably in systemic lupus erythematosus (SLE) and most biomarker associations remain to be prospectively validated. This study examined a disease inception cohort of 1047 SLE patients to determine which autoantibodies at enrolment predicted subsequent neuropsychiatric events. Methods Patients with a recent SLE diagnosis were assessed prospectively for up to 10 years for neuropsychiatric events using the American College of Rheumatology case definitions. Decision rules of graded stringency determined whether neuropsychiatric events were attributable to SLE. Associations between the first neuropsychiatric event and baseline autoantibodies (lupus anticoagulant (LA), anticardiolipin, anti-beta(2)... (More)
Objective Neuropsychiatric events occur unpredictably in systemic lupus erythematosus (SLE) and most biomarker associations remain to be prospectively validated. This study examined a disease inception cohort of 1047 SLE patients to determine which autoantibodies at enrolment predicted subsequent neuropsychiatric events. Methods Patients with a recent SLE diagnosis were assessed prospectively for up to 10 years for neuropsychiatric events using the American College of Rheumatology case definitions. Decision rules of graded stringency determined whether neuropsychiatric events were attributable to SLE. Associations between the first neuropsychiatric event and baseline autoantibodies (lupus anticoagulant (LA), anticardiolipin, anti-beta(2) glycoprotein-I, anti-ribosomal P and anti-NR2 glutamate receptor) were tested by Cox proportional hazards regression. Results Disease duration at enrolment was 5.4 +/- 4.2 months, follow-up was 3.6 +/- 2.6 years. Patients were 89.1% female with mean (+/- SD) age 35.2 +/- 13.7 years. 495/1047 (47.3%) developed one or more neuropsychiatric event (total 917 events). Neuropsychiatric events attributed to SLE were 15.4% (model A) and 28.2% (model B). At enrolment 21.9% of patients had LA, 13.4% anticardiolipin, 15.1% anti-beta(2) glycoprotein-I, 9.2% anti-ribosomal P and 13.7% anti-NR2 antibodies. LA at baseline was associated with subsequent intracranial thrombosis (total n=22) attributed to SLE (model B) (HR 2.54, 95% CI 1.08 to 5.94). Anti-ribosomal P antibody was associated with subsequent psychosis (total n=14) attributed to SLE (model B) (HR 3.92, 95% CI 1.23 to 12.5, p=0.02). Other autoantibodies did not predict neuropsychiatric events. Conclusion In a prospective study of 1047 recently diagnosed SLE patients, LA and anti-ribosomal P antibodies are associated with an increased future risk of intracranial thrombosis and lupus psychosis, respectively. (Less)
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Annals of the Rheumatic Diseases
volume
70
issue
10
pages
1726 - 1732
publisher
British Medical Association
external identifiers
  • wos:000294491600005
  • scopus:80052444139
ISSN
1468-2060
DOI
10.1136/ard.2010.148502
language
English
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yes
id
389a5149-2c3b-4c30-bb35-383fc4db8fc0 (old id 2160791)
date added to LUP
2011-10-03 08:30:49
date last changed
2017-11-05 04:11:53
@article{389a5149-2c3b-4c30-bb35-383fc4db8fc0,
  abstract     = {Objective Neuropsychiatric events occur unpredictably in systemic lupus erythematosus (SLE) and most biomarker associations remain to be prospectively validated. This study examined a disease inception cohort of 1047 SLE patients to determine which autoantibodies at enrolment predicted subsequent neuropsychiatric events. Methods Patients with a recent SLE diagnosis were assessed prospectively for up to 10 years for neuropsychiatric events using the American College of Rheumatology case definitions. Decision rules of graded stringency determined whether neuropsychiatric events were attributable to SLE. Associations between the first neuropsychiatric event and baseline autoantibodies (lupus anticoagulant (LA), anticardiolipin, anti-beta(2) glycoprotein-I, anti-ribosomal P and anti-NR2 glutamate receptor) were tested by Cox proportional hazards regression. Results Disease duration at enrolment was 5.4 +/- 4.2 months, follow-up was 3.6 +/- 2.6 years. Patients were 89.1% female with mean (+/- SD) age 35.2 +/- 13.7 years. 495/1047 (47.3%) developed one or more neuropsychiatric event (total 917 events). Neuropsychiatric events attributed to SLE were 15.4% (model A) and 28.2% (model B). At enrolment 21.9% of patients had LA, 13.4% anticardiolipin, 15.1% anti-beta(2) glycoprotein-I, 9.2% anti-ribosomal P and 13.7% anti-NR2 antibodies. LA at baseline was associated with subsequent intracranial thrombosis (total n=22) attributed to SLE (model B) (HR 2.54, 95% CI 1.08 to 5.94). Anti-ribosomal P antibody was associated with subsequent psychosis (total n=14) attributed to SLE (model B) (HR 3.92, 95% CI 1.23 to 12.5, p=0.02). Other autoantibodies did not predict neuropsychiatric events. Conclusion In a prospective study of 1047 recently diagnosed SLE patients, LA and anti-ribosomal P antibodies are associated with an increased future risk of intracranial thrombosis and lupus psychosis, respectively.},
  author       = {Hanly, J. G. and Urowitz, M. B. and Su, L. and Bae, S-C and Gordon, C. and Clarke, A. and Bernatsky, S. and Vasudevan, A. and Isenberg, D. and Rahman, A. and Wallace, D. J. and Fortin, P. R. and Gladman, D. and Romero-Dirz, J. and Sanchez-Guerrero, J. and Dooley, M. A. and Bruce, I. and Steinsson, K. and Khamashta, M. and Manzi, S. and Ramsey-Goldman, R. and Sturfelt, Gunnar and Nived, Ola and van Vollenhoven, R. and Ramos-Casals, M. and Aranow, C. and Mackay, M. and Kalunian, K. and Alarcon, G. S. and Fessler, B. J. and Ruiz-Irastorza, G. and Petri, M. and Lim, S. and Kamen, D. and Peschken, C. and Farewell, V. and Thompson, K. and Theriault, C. and Merrill, J. T.},
  issn         = {1468-2060},
  language     = {eng},
  number       = {10},
  pages        = {1726--1732},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus},
  url          = {http://dx.doi.org/10.1136/ard.2010.148502},
  volume       = {70},
  year         = {2011},
}