Hanly JG, et al. - This study entailed an examination of a multi-ethnic/racial, prospective, SLE disease inception cohort, for the determination of the frequency, associations, and outcomes of cerebrovascular events (CerVEs) in these subjects. Lupus was shown to be usually responsible for CerVEs, the 4th most frequent neuropsychiatric (NP) event in SLE. After CerVEs, a sustained reduction in health-related quality of life was reported by patients, in contrast to good physician reported outcomes.

Methods

• An annual assessment was carried out in patients, for 19 neuropsychiatric (NP) events including 5 types of CerVEs: Stroke; Transient ischemia; Chronic multifocal ischemia; Subarachnoid/intracranial hemorrhage; Sinus thrombosis.
• Researchers gathered Global disease activity (SLEDAI-2K), SLICC/ACR damage index (SDI) and SF-36 scores.
• As appropriate, time to event, linear and logistic regressions and multi-state models were used.

Results

• This study included a total of 1,826 SLE patients, including 88.8% female, 48.8% Caucasian, mean±SD age 35.1±13.3 years, disease duration 5.6±4.2 months and follow-up 6.6±4.1 years.
• Data showed that CerVEs were the 4th most frequent NP event: 82/1,826 (4.5%) patients had 109 events, 103/109 (94.5%) were attributed to SLE and 44/109 (40.4%) were identified at enrollment.
• Stroke [60/109 (55.0%)] and transient ischemia [28/109 (25.7%)] were reported as predominant events.
• Researchers observed association of CerVEs with other NP events attributed to SLE (HR (95% CI): (3.16; 1.73-5.75) (p<0.001), non-SLE NP (2.60; 1.49-4.51) (p<0.001), African ancestry at US SLICC sites (2.04; 1.01-4.13) (p=0.047) and organ damage (p=0.041).
• They also noted that lupus anticoagulant increased the risk of first stroke and sinus thrombosis [2.23 (1.11, 4.45) p=.024] and TIA [3.01 (1.15, 7.90) p=0.025].
• As per the physician assessment, resolution or improvement was indicated in the majority but sustained reduction in SF-36 summary and subscale scores following CerVEs (P<0.0001) was reported by patients.