Cognitive Impairment and SLE

[clears throat]

...

in Patients with Systemic Lupus Erythematosus.

Murray, can you please comment a little bit on how you have seen cognitive impairment in systemic lupus erythematosus along the last decades of your experience?

Well, Raquel, it's, [clears throat] uh, it's good that we're focusing on this area because it's still an area that needs a lot of development.

So we've been very interested in patients' symptoms.

You know, "I can't think straight.

I'm, uh, losing my memory," et cetera, et cetera.

Brain fog.

And we actually, back in 1997, did a study showing that patients with inactive lupus, right? So n- no detection of active lupus anywhere, had significant cognitive impairment, maybe in about half the patients, uh, but ...

and twice as much as, as you could see in normal age-matched controls.

So-

Mm-hmm

...

there was no doubt cognitive impairment was there.

Patients were correct, and they were different from controls, and it wasn't necessarily a- related to active lupus.

And when we actually tried to look later on, on the predictive factors, you know, how, how could, uh, how can we believe them? What, what predicts this, this, uh, cognitive impairment? We really couldn't find anything.

You know, we found older age or diffuse vasculitis, which is understandable, but nothing specific.

Okay.

So, uh, it, it's there.

It's not clear as what it's related to.

So what do we do for it? So when the patient compai- When, when we see the patient now, if they complain of cognitive impairment, then we go through the usual active disease measures.

Is this part of active lupus? And if it is, then we treat the active lupus and hope the cognitive impairment will improve.

If it's not associated with very significant active disease, we look for other factors.

[lips smack] And here's where the problem is.