The Impact of Asthma and Chronic Obstructive Pulmonary Disease (COPD) on Patient-Reported Outcomes in Systemic Lupus Erythematosus (SLE)

Background: 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]). Methods: 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. Results: 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. Conclusion: 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.