TY - JOUR
T1 - Headache in Systemic Lupus Erythematosus Results From a Prospective, International Inception Cohort Study
AU - Hanly, John G.
AU - Urowitz, Murray B.
AU - O'Keeffe, Aidan G.
AU - Gordon, Caroline
AU - Bae, Sang-Cheol
AU - Sanchez-Guerrero, Jorge
AU - Romero-Diaz, Juanita
AU - Clarke, Ann E.
AU - Bernatsky, Sasha
AU - Wallace, Daniel J.
AU - Ginzler, Ellen M.
AU - Isenberg, David A.
AU - Rahman, Anisur
AU - Merrill, Joan T.
AU - Petri, Michelle
AU - Fortin, Paul R.
AU - Gladman, Dafna D.
AU - Fessler, Barri J.
AU - Alarcón, Graciela S.
AU - Bruce, Ian N.
AU - Dooley, Mary Anne
AU - Steinsson, Kristjan
AU - Khamashta, Munther A.
AU - Ramsey-Goldman, Rosalind
AU - Manzi, Susan
AU - Sturfelt, Gunnar K.
AU - Nived, Ola
AU - Zoma, Asad A.
AU - van Vollenhoven, Ronald F.
AU - Ramos-Casals, Manuel
AU - Aranow, Cynthia
AU - Mackay, Meggan
AU - Ruiz-Irastorza, Guillermo
AU - Kalunian, Kenneth C.
AU - Lim, S. Sam
AU - Inanc, Murat
AU - Kamen, Diane L.
AU - Peschken, Christine A.
AU - Jacobsen, Soren
AU - Theriault, Chris
AU - Thompson, Kara
AU - Farewell, Vernon
PY - 2013
Y1 - 2013
N2 - ObjectiveTo examine the frequency and characteristics of headaches and their association with global disease activity and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE). MethodsA disease inception cohort was assessed annually for headache (5 types) and 18 other neuropsychiatric (NP) events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 (SF-36) mental and physical component summary scores were collected. Time to first headache and associations with SF-36 scores were analyzed using Cox proportional hazards and linear regression models with generalized estimating equations. ResultsAmong the 1,732 SLE patients enrolled, 89.3% were female and 48.3% were white. The mean SD age was 34.6 +/- 13.4 years, duration of disease was 5.6 +/- 5.2 months, and length of followup was 3.8 +/- 3.1 years. At enrollment, 17.8% of patients had headache (migraine [60.7%], tension [38.6%], intractable nonspecific [7.1%], cluster [2.6%], and intracranial hypertension [1.0%]). The prevalence of headache increased to 58% after 10 years. Only 1.5% of patients had lupus headache, as identified in the SLEDAI-2K. In addition, headache was associated with other NP events attributed to either SLE or non-SLE causes. There was no association of headache with SLEDAI-2K scores (without the lupus headache variable), SDI scores, use of corticosteroids, use of antimalarials, use of immunosuppressive medications, or specific autoantibodies. SF-36 mental component scores were lower in patients with headache compared with those without headache (mean +/- SD 42.5 +/- 12.2 versus 47.8 +/- 11.3; P <0.001), and similar differences in physical component scores were seen (38.0 +/- 11.0 in those with headache versus 42.6 +/- 11.4 in those without headache; P <0.001). In 56.1% of patients, the headaches resolved over followup. ConclusionHeadache is frequent in SLE, but overall, it is not associated with global disease activity or specific autoantibodies. Although headaches are associated with a lower HRQOL, the majority of headaches resolve over time, independent of lupus-specific therapies
AB - ObjectiveTo examine the frequency and characteristics of headaches and their association with global disease activity and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE). MethodsA disease inception cohort was assessed annually for headache (5 types) and 18 other neuropsychiatric (NP) events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 (SF-36) mental and physical component summary scores were collected. Time to first headache and associations with SF-36 scores were analyzed using Cox proportional hazards and linear regression models with generalized estimating equations. ResultsAmong the 1,732 SLE patients enrolled, 89.3% were female and 48.3% were white. The mean SD age was 34.6 +/- 13.4 years, duration of disease was 5.6 +/- 5.2 months, and length of followup was 3.8 +/- 3.1 years. At enrollment, 17.8% of patients had headache (migraine [60.7%], tension [38.6%], intractable nonspecific [7.1%], cluster [2.6%], and intracranial hypertension [1.0%]). The prevalence of headache increased to 58% after 10 years. Only 1.5% of patients had lupus headache, as identified in the SLEDAI-2K. In addition, headache was associated with other NP events attributed to either SLE or non-SLE causes. There was no association of headache with SLEDAI-2K scores (without the lupus headache variable), SDI scores, use of corticosteroids, use of antimalarials, use of immunosuppressive medications, or specific autoantibodies. SF-36 mental component scores were lower in patients with headache compared with those without headache (mean +/- SD 42.5 +/- 12.2 versus 47.8 +/- 11.3; P <0.001), and similar differences in physical component scores were seen (38.0 +/- 11.0 in those with headache versus 42.6 +/- 11.4 in those without headache; P <0.001). In 56.1% of patients, the headaches resolved over followup. ConclusionHeadache is frequent in SLE, but overall, it is not associated with global disease activity or specific autoantibodies. Although headaches are associated with a lower HRQOL, the majority of headaches resolve over time, independent of lupus-specific therapies
U2 - https://doi.org/10.1002/art.38106
DO - https://doi.org/10.1002/art.38106
M3 - Article
C2 - 24166793
SN - 0004-3591
VL - 65
SP - 2887
EP - 2897
JO - Arthritis and rheumatism
JF - Arthritis and rheumatism
IS - 11
ER -