Association of mycophenolate and azathioprine use with cognitive function in systemic lupus

Autor: Chrisanna Dobrowolski, John McGinley, Melissa Fazzari, Jiandong Su, Kathleen S Bingham, Nicole Anderson, Lesley Ruttan, Dorcas E Beaton, Joan E Wither, Maria Carmela Tartaglia, Mahta Kakvan, Dennisse Bonilla, May Y Choi, Marvin J Fritzler, Juan Pablo Diaz Martinez, Patricia Katz, Robin Green, Chaim Putterman, Zahi Touma
Rok vydání: 2022
Předmět:
Zdroj: Rheumatology. 62:1860-1869
ISSN: 1462-0332
1462-0324
Popis: Objectives Cognitive dysfunction (CD) is a common manifestation of SLE that can have detrimental consequences for those affected. To date, no treatments have been approved for SLE-CD. This study aims to assess the association of azathioprine (AZA) and mycophenolate (MMF) use with SLE-CD, given that these medications have demonstrated neuroprotective qualities in prior studies. Methods Consecutive adult SLE patients presenting to a single healthcare center were considered for participation. The ACR neuropsychological battery for SLE was administered to consenting patients at 0, 6 and 12 months. Scores were compared with age- and sex-matched controls. Primary outcome was CD, defined as a z-score ≤−1.5 in two or more cognitive domains. Mixed-effects logistic regression models were constructed to estimate the odds of CD with respect to AZA and MMF use. Results A total of 300 participants representing 676 patient visits completed the study; 114 (38%) met criteria for CD at baseline. The cumulative AZA dose (g/kg) was associated with reduced odds of CD [odds ratio (OR) 0.76 (95% CI 0.58, 0.98), P = 0.04]. Years of AZA treatment was also associated with reduced odds of CD [OR 0.72 (95% CI 0.54, 0.97), P = 0.03]. MMF use was not associated with CD. Conclusion AZA use was associated with significantly lower odds of SLE-CD, while MMF use was not. Additional studies are warranted to further investigate the relationship of AZA and SLE-CD.
Databáze: OpenAIRE
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