Peripheral Nervous System Events Not Common in Lupus

Peripheral nervous system (PNS) disease is a component of systemic lupus erythematosus (SLE) disease activity and has a significant negative impact on health-related quality of life, according to a study published in the January issue of Arthritis & Rheumatology.

John G. Hanly, M.D., from the Queen Elizabeth II Health Sciences Center and Dalhousie University in Halifax, Nova Scotia, Canada, and colleagues assessed a cohort of 1,827 SLE patients (88.8 percent female; mean age, 35.1 years) annually for 19 neuropsychiatric (NP) events, including seven types of PNS disease. The authors also measured SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome.

The researchers found that during an average 7.6 years of follow-up, PNS events occurred in 7.6 percent of patients. The most common PNS events included peripheral neuropathy (41.0 percent), mononeuropathy (27.3 percent), and cranial neuropathy (24.2 percent), with the majority attributed to SLE. PNS events were associated with longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and peripheral neuropathy versus other neuropathies. Compared with patients with no NP events, neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores. The majority of neuropathies resolved or improved over time, according to physician assessment, with resolution associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy.

"Overall, the results of our study provide a comprehensive overview of the frequency and characteristics of PNS disease in SLE patients, the impact on health-related quality of life, and the outcome with current treatment modalities for SLE," the authors write.

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