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Time to seizure occurrence and damage in PROFILE, a multi-ethnic systemic lupus erythematosus cohort

Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

GS Alarcón

Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, the University of Alabama at Birmingham, Birmingham, Alabama, USA; The Department of Epidemiology, School of Public Health, the University of Alabama at Birmingham, Birmingham, Alabama, USA

G McGwin

The Department of Epidemiology, School of Public Health, the University of Alabama at Birmingham, Birmingham, Alabama, USA

M Petri

Division of Rheumatology, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA

LM Vilá

Division of Rheumatology, Department of Medicine, the University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico, USA

JC Edberg

Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, the University of Alabama at Birmingham, Birmingham, Alabama, USA

JD Reveille

Division of Rheumatology, Department of Medicine, School of Medicine, the University of Texas Health Science Center at Houston, Houston, Texas, USA

RP Kimberly, for the PROFILE Study Group

Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, the University of Alabama at Birmingham, Birmingham, Alabama, USA

Abstract

The objective of this study was to determine risk factors predicting seizures and damage caused by seizures in a multi-ethnic systemic lupus erythematosus cohort (PROFILE) that includes systemic lupus erythematosus patients (n�=�1295) from five different US institutions. Only patients with seizures after systemic lupus erythematosus diagnosis (incident) were included in the analyses of clinical seizures (80/1295, 6.2%), but all patients (prevalent and incident) were included in the analyses of damage caused by seizures (51/1295, 3.9%). We examined socioeconomic–demographic, clinical, and genetic variables predictive of clinical seizures and damage from seizures by Cox proportional hazard ratios (HR) and 95% confidence intervals (CI). Independent predictors of a shorter time to the occurrence of clinical seizures were younger age (HR�=�1.0; 95% CI 0.9–1.0), having Hispanic-Texan ethnicity (HR�=�2.7; 95% CI 1.3–5.7) or African-American ethnicity (HR�=�1.8; 95% CI 1.0–3.1), and the previous occurrence of a cerebrovascular accident (HR�=�3.3; 95% CI 1.6–7.1) or an episode of psychosis (HR�=�2.4; 95% CI 1.1–5.0), whereas the previous occurrence of photosensitivity (HR�=�0.5; 95% CI 0.3–0.9) was the only independent predictor of a longer time to the occurrence of clinical seizures. Independent predictors of a shorter time to the occurrence of damage caused by seizures were younger age (HR�=�1.0; 95% CI 0.9–1.0), male gender (HR�=�2.4; 95% CI 1.1–5.4), and the occurrence of a previous cerebrovascular accident (HR�=�2.7; 95% CI 1.0–7.0) or an episode of psychosis (HR�=�4.7; 95% CI 2.3–9.9). No allele from the candidate genes examined (HLA-DRB1, HLA-DQB1, FCGR2A, FCGR3A, or FCG3B) predicted clinical seizures or damage caused by seizures.

Key Words: seizures • lupus • PROFILE

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