Neurocognitive Dysfunction in Systemic Lupus Erythematosus: Association with Antiphospholipid Antibodies, Disease Activity and Chronic Damage

Introduction: Systemic lupus erythematosus (SLE) is characterized by frequent neuropsychiatric involvement, which includes cognitive impairment (CI). We aimed at assessing CI in a cohort of Italian SLE patients by using a wide range of neurocognitive tests specifically designed to evaluate the fronto-subcortical dysfunction. Furthermore, we aimed at testing whether CI in SLE is associated with serum autoantibodies, disease activity and chronic damage. Methods: Fifty-eight consecutive patients were enrolled. Study protocol included data collection, evaluation of serum level

Measuring and monitoring health-related quality of life responsiveness in systemic lupus erythematosus patients: current perspectives

Jamal Mikdashi Division of Rheumatology and Clinical Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA Objective: Little is known about health-related quality of life (HRQoL) responsiveness in systemic lupus erythematosus (SLE) patients, compared to other chronic diseases. This review summarizes the available data in HRQoL responsiveness and sensitivity to change in SLE, and recommends directions for research and clinical application. Methods: A review of the literature was conducted reporting on HRQoL responsiveness in adult SLE patients between 1984 and 2018. HRQoL studies were assessed for responsiveness, sensitivity of change, minimal important differences, minimal clinical important differences, or change in improvement or deterioration. Results: Responsiveness or sensitivity to change in health-related status was observed in Medical Outcome Survey Short Form-36, SLE Symptom Checklist, EuroQoL, and Medical Outcomes Study Short Form 6D. SLE-specific quality of life questionnaire demonstrated greater responsiveness than the individual domains of SF-36. Lupus quality of life showed large responsiveness when there was improvement. LupusPRO and its derivative Lupus Impact Tracker were found to be responsive to change in disease activity, reflecting both improvement and worsening. Lupus Impact Tracker and physical health and pain domains of Lupus quality of life were responsive to SLE composite responder index. Conclusion: This review highlights the need for further studies that capture responsiveness and change in HRQoL that are clinically meaningful and sustained. Most importantly, the choice of one measure over another is influenced by the purpose of the HRQoL measure, the particular HRQoL domain, and the SLE disease state that are relevant to the research question. Keywords: quality of life, systemic lupus, measurements, monitorin