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Unveiling the Link Between Antiphospholipid Antibodies and Cognitive Dysfunction in the Almenara Lupus Cohort

  • Yelitza Velarde-Mejía
    ,
  • ,
  • Francisco Zevallos
    ,
  • Mariela Medina
    ,
  • Zoila Rodriguez-Bellido
    ,
  • Cesar Pastor-Asurza
  • Hospital Nacional Carlos Alberto Seguin Escobedo, EsSalud
    ,
  • ,
  • Hospital Guillermo Almenara Irigoyen
    ,
  • Universidad Nacional Mayor de San Marcos
    ,
  • Universidad Peruana Cayetano Heredia
    ,
  • University of Alabama at Birmingham School of Medicine
Research Output:
Contribution to journal
Article
Peer-review

Publication Information

Output type

Research Output:
Contribution to journal
Article
Peer-review

Original language

English

Pages from-to (Number of pages)

Pages 41-45 (5 pages)

Journal (Volume, Issue Number)

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases (Volume 30, Issue 2)

Publication milestones

  • Published - 01/03/2024

Publication status

Published - 01/03/2024

ISSN

1076-1608

Publication IDs

  • Scopus: 85185614757
  • PubMed: 38115180

Abstract

Objective: Cognitive dysfunction is a prevalent manifestation of systemic lupus erythematosus (SLE). There is evidence for the role of antiphospholipid (aPL) antibodies on its etiopathogenesis. Our objective was to identify the association between aPL antibodies and cognitive dysfunction in SLE patients. Methods: This cross-sectional study included 135 patients evaluated from March 2015 to October 2017 at one center. Cognitive deficit was measured using the NEUROPSI test. Disease activity and damage were ascertained using the SLEDAI-2K (SLE Disease Activity Index 2000) and the SDI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), respectively; aPL antibodies were measured by enzyme-linked immunosorbent assay. The association between cognitive dysfunction and aPL antibodies was evaluated using univariable and multivariable linear regression models adjusted for age, sex, education, socioeconomic status, disease duration, SLEDAI-2K, SDI, mean current dose of prednisone, time of exposure to glucocorticoids, and drug use (immunosuppressants, hydroxychloroquine, aspirin, and warfarin). Results: One hundred thirty-one patients (97.1%) were women; their mean (SD) age was 46.6 (12.5) years; 59 patients (43.7%) had positivity for at least 1 aPL antibody. IgM anticardiolipin (aCL) was positive in 24.5%, IgG in 13.5%, IgM aβ2GP1 in 16.8%, IgG anti-β2 glycoprotein in 24.6%, and the lupus anticoagulant in 5.3%. Ninety patients (66.7%) had some cognitive dysfunction. In the univariable analysis, a significant correlation between the NEUROPSI score and IgM aCL antibodies was found (B = −20.87 [SE, 3.2]; p < 0.001), which remained significant in the multivariable model (B = −13.89 [SE, 3.14]; p < 0.001). Conclusions: IgM aCL antibodies are associated with cognitive dysfunction in patients with SLE. Larger and longitudinal studies are needed to assess the impact of these findings.

Funding Details

These analyses were done as a part of a Research Grant from Janssen. In addition, the Almenara Lupus Cohort has been partially supported by institutional grants from EsSalud (1483-GCGP-ESSALUD-2013, 1733-GCGP-ESSALUD-2014, and the 2015 Kaelin Prize 04-IETSI-ESALUD-2016), from the Pan American League of Associations for Rheumatology (PANLAR) (2015 PANLAR Prize and the 2018 H. Ralph Schumacher MD/JCR/PANLAR Prize), and from the Fundación Instituto Hipólito Unanue, Lima, Perú.
FundersFunding numbers
EsSalud
04-IETSI-ESALUD-2016, 1733-GCGP-ESSALUD-2014, 1483-GCGP-ESSALUD-2013
Fundación Instituto Hipólito Unanue
-
Pan American League of Associations for Rheumatology
-