Katz Patricia, Pedro Sofia, Trupin Laura, Yelin Edward, Michaud Kaleb
University of California San Francisco, San Francisco, California.
FORWARD, the National Databank for Rheumatic Diseases, Wichita, Kansas.
ACR Open Rheumatol. 2021 Apr;3(4):221-230. doi: 10.1002/acr2.11212. Epub 2021 Feb 20.
Risk of asthma and chronic obstructive pulmonary disease (COPD) may be elevated in systemic lupus erythematosus (SLE), but little research has studied the impact of these conditions on SLE outcomes. We examined prevalence, incidence, and impact of self-reported asthma and COPD in two US-based SLE cohorts (FORWARD and Lupus Outcomes Study [LOS]).
Prevalence of asthma and COPD were defined as presence of conditions at individuals' first interviews; incidence was defined as new reports over the next 3 years. Cross-sectional associations of asthma/COPD with patient-reported outcomes (PROs) and longitudinal analyses associations with asthma/COPD at entry with PROs 3 years later were examined.
In FORWARD, 19.8% and 8.3% participants reported asthma and COPD, respectively, at entry. In LOS, 36.0% reported the presence of either (US population comparisons: asthma, 9.7%; COPD, 6.1%). Cross-sectionally, asthma/COPD was associated with worse PROs, including disease activity. In FORWARD, individuals with asthma experienced greater worsening of fatigue, pain, and global health ratings longitudinally; individuals with COPD experienced greater increases in self-reported SLE activity. However, no such patterns were noted in the LOS.
Asthma and COPD appeared to be more common in SLE than in the general US population and were associated with worse status on PROs cross-sectionally. Asthma was linked to decrements in PROs longitudinally.
系统性红斑狼疮（SLE）患者患哮喘和慢性阻塞性肺疾病（COPD）的风险可能会升高，但很少有研究探讨这些疾病对SLE预后的影响。我们在美国的两个SLE队列（FORWARD和狼疮预后研究[LOS]）中研究了自我报告的哮喘和COPD的患病率、发病率及其影响。
哮喘和COPD的患病率定义为个体首次访谈时存在这些疾病；发病率定义为接下来3年中的新报告病例。研究了哮喘/COPD与患者报告结局（PROs）的横断面关联，以及入组时患有哮喘/COPD与3年后PROs的纵向分析关联。
在FORWARD队列中，分别有19.8%和8.3%的参与者在入组时报告患有哮喘和COPD。在LOS队列中，36.0%的参与者报告患有其中一种疾病（与美国总体人群比较：哮喘患病率为9.7%；COPD患病率为6.1%）。横断面分析显示，哮喘/COPD与更差的PROs相关，包括疾病活动度。在FORWARD队列中，患有哮喘的个体在纵向观察中疲劳、疼痛和整体健康评分恶化更明显；患有COPD的个体自我报告的SLE活动度增加更显著。然而，在LOS队列中未观察到此类模式。
哮喘和COPD在SLE患者中似乎比在美国普通人群中更常见，并且在横断面分析中与更差的PROs状态相关。哮喘在纵向观察中与PROs的下降有关。
