Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study

Objectives Pulmonary involvement is common in systemic lupus erythematosus (SLE), but the relative risk of pulmonary manifestations in SLE versus non-SLE subjects remains unclear. This study aimed to evaluate the risk of pulmonary manifestations in SLE subjects compared with matched controls.Methods...

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Main Authors: Hyun Lee, Bo-Guen Kim, Yeonghee Eun, Dong Won Park, Sang-Heon Kim, Jiyeong Kim
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/1/e005267.full
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author Hyun Lee
Bo-Guen Kim
Yeonghee Eun
Dong Won Park
Sang-Heon Kim
Jiyeong Kim
author_facet Hyun Lee
Bo-Guen Kim
Yeonghee Eun
Dong Won Park
Sang-Heon Kim
Jiyeong Kim
author_sort Hyun Lee
collection DOAJ
description Objectives Pulmonary involvement is common in systemic lupus erythematosus (SLE), but the relative risk of pulmonary manifestations in SLE versus non-SLE subjects remains unclear. This study aimed to evaluate the risk of pulmonary manifestations in SLE subjects compared with matched controls.Methods Using data from the Korean National Health Insurance Service (2009–2017), we identified 6074 individuals aged ≥20 years with newly diagnosed SLE and 60 740 matched controls by age and sex (1:10 ratio) who did not have prior pulmonary manifestations.Results Over a mean follow-up of 9.3±2.7 years, the incidence of pulmonary manifestations was 15.2 per 1000 person-years in the SLE cohort and 4.5 per 1000 person-years in the matched cohort. The SLE cohort had a significantly higher risk of pulmonary manifestations (adjusted HR (aHR) 3.26; 95% CI 2.99 to 3.56). The highest risk was observed for pulmonary hypertension (aHR 14.66; 95% CI 9.43 to 22.80), followed by interstitial lung disease (aHR 9.58; 95% CI 7.99 to 11.49), pleural disorders (aHR 3.29; 95% CI 2.84 to 3.81), pulmonary embolism (aHR 2.66; 95% CI 2.06 to 3.43), tuberculosis (aHR 2.35; 95% CI 1.88 to 2.93), acute respiratory distress syndrome and haemorrhage (aHR 1.85; 95% CI 1.51 to 2.25) and lung cancer (aHR 1.41; 95% CI 1.02 to 1.95).Conclusions Subjects with SLE have an approximately 3.3-fold higher risk of pulmonary manifestations compared with matched controls. Notably, the risks of pulmonary hypertension and interstitial lung disease are particularly elevated.
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spelling doaj-art-cee8164354524e8c80b5757f29d238422025-08-20T02:45:09ZengBMJ Publishing GroupRMD Open2056-59332025-02-0111110.1136/rmdopen-2024-005267Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal studyHyun Lee0Bo-Guen Kim1Yeonghee Eun2Dong Won Park3Sang-Heon Kim4Jiyeong Kim5Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea (the Republic of)1College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Seoul, Korea (the Republic of)Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea (the Republic of)2Hanyang University College of Medicine, Internal Medicine, Seoul, Korea, Rep. of (South Korea)Department of Pre-Medicine, Hanyang University, Seoul, Korea (the Republic of)Objectives Pulmonary involvement is common in systemic lupus erythematosus (SLE), but the relative risk of pulmonary manifestations in SLE versus non-SLE subjects remains unclear. This study aimed to evaluate the risk of pulmonary manifestations in SLE subjects compared with matched controls.Methods Using data from the Korean National Health Insurance Service (2009–2017), we identified 6074 individuals aged ≥20 years with newly diagnosed SLE and 60 740 matched controls by age and sex (1:10 ratio) who did not have prior pulmonary manifestations.Results Over a mean follow-up of 9.3±2.7 years, the incidence of pulmonary manifestations was 15.2 per 1000 person-years in the SLE cohort and 4.5 per 1000 person-years in the matched cohort. The SLE cohort had a significantly higher risk of pulmonary manifestations (adjusted HR (aHR) 3.26; 95% CI 2.99 to 3.56). The highest risk was observed for pulmonary hypertension (aHR 14.66; 95% CI 9.43 to 22.80), followed by interstitial lung disease (aHR 9.58; 95% CI 7.99 to 11.49), pleural disorders (aHR 3.29; 95% CI 2.84 to 3.81), pulmonary embolism (aHR 2.66; 95% CI 2.06 to 3.43), tuberculosis (aHR 2.35; 95% CI 1.88 to 2.93), acute respiratory distress syndrome and haemorrhage (aHR 1.85; 95% CI 1.51 to 2.25) and lung cancer (aHR 1.41; 95% CI 1.02 to 1.95).Conclusions Subjects with SLE have an approximately 3.3-fold higher risk of pulmonary manifestations compared with matched controls. Notably, the risks of pulmonary hypertension and interstitial lung disease are particularly elevated.https://rmdopen.bmj.com/content/11/1/e005267.full
spellingShingle Hyun Lee
Bo-Guen Kim
Yeonghee Eun
Dong Won Park
Sang-Heon Kim
Jiyeong Kim
Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study
RMD Open
title Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study
title_full Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study
title_fullStr Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study
title_full_unstemmed Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study
title_short Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study
title_sort comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus a large scale korean population based longitudinal study
url https://rmdopen.bmj.com/content/11/1/e005267.full
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