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Cognitive impairment may improve in many patients with SLE over time

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Cognitive impairment experienced by patients with systemic lupus erythematosus may improve over time or remain stable for most patients after 10 years of follow-up, but may worsen for a smaller subset of patients, according to recently presented research.

A group of 43 patients with systemic lupus erythematosus (SLE) evaluated at baseline (T0) and after 10 years of follow-up (T1). Serum levels of anti-nuclear antibodies (ANA), anti-dsDNA, anti-cardiolipin, anti2-glycoprotein, and anti-endothelial cell antibodies and lupus anticoagulant were analyzed. Disease activity and damage were assessed using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and damage index and a battery of tests designed to detect fronto-subcortical dysfunction were administered. The tests assessed function across five domains, including memory, attention, abstract reasoning, executive function and visuospatial function during both evaluations at T0 and T1 by the same neurologist.

Raw test scores were compared with published averages in the general population, converted to Z scores and totaled in the Global Cognitive Dysfunction score (GCDs).

Mild or moderate cognitive impairment (CI) was evident in 20.9% of patients at T0 and in 13.9% of patients at T1. Mild CI was seen in just over half of patients with CI at T0 and about 36% of patients at T1 were categorized as mild or moderate.

Further analysis showed that CI improved in about 50% of patients, remained stable in about 40% of patients and worsened in 10% of patients with SLE. All domains improved at T1 with a significant difference revealed for executive function. Dyslipidemia was associated with all domains except attention, and lupus anticoagulant was associated with visuospatial function.

“These results could suggest that an appropriate management of the disease during the follow-up was able to control SLE-related CI,” the researchers concluded. – by Shirley Pulawski

Reference:

Ceccarelli, et al. Paper #SAT0398. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology. June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.