Neuropsychiatric SLE - 2/3 Improved at 12 Months

The management and outcomes of neuropsychiatric systemic lupus erythematosus (NPSLE) can be challenging as there is limited data. 

A retrospective cohort study identified 350 NPSLE events (between 1999-2015) defined by ACR definitions and categorized as being: central/diffuse, central/focal and peripheral. Clinical outcomes and predictors of clinical improvement/resolution were investigated. 

NPSLE patients had an average age of 40 years. The diagnosis of NP-SLE (OR 4.32) and a SLEDAI-2K scores of at least 6 (OR  5.64) increased likelihood of initiating immunosuppressive therapy for NP events. Other takeaways from this study: 

  • Immunosuppressants and corticosteroids were frequently initiated/escalated for central diffuse or focal NP manifestations
  • At 12 months, two-thirds (64%) showed a improvement in NP manifestations.
    • Higher rated of improvement seen with Focal central NPSLE events 
  • NPSLE manifestations treated with immunosuppressants had higher odds of clinical response (OR 2.55)
  • Age at diagnosis and focal central events emerged as additional response predictors.
Two-thirds of patients with NPSLE are improved by 12 mos. This is facilitated by NP diagnosis and treating with immunosuppressants.
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Therapeutic strategies and outcomes in neuropsychiatric systemic lupus erythematosus: an international multicentre retrospective study

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The author has no conflicts of interest to disclose related to this subject
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