LAUSR

Rationale and aims People with severe asthma report both pulmonary specific symptoms and systemic symptoms. The aim was to survey the frequency of extra-pulmonary versus pulmonary symptoms as reported by people with severe asthma, and their contribution to quality of life and relationship to treatment. Methods Consenting patients attending a severe asthma clinic completed a questionnaire measure of a large range of general symptoms using the General Symptom Questionnaire, (GSQ), pulmonary symptoms using the Asthma Control Test (ACT) and disease specific quality of life using the Severe Asthma Questionnaire (SAQ). Correlations are Pearson correlations, and simultaneous linear regression was used to calculate the independent contribution of the ACT and GSQ to the SAQ. Results A median of 21 extra-pulmonary symptoms were reported per week. GSQ correlated -0.65 with the ACT and 0.69 with the SAQ. The beta for GSQ was -0.43 and for the ACT 0.41, both p<0.001, R2=0.57. There was a non-significant trend (p=0.32) for those on biologics to have less non-respiratory symptoms compared to those not on biologics (2.79 vs 3.01) as indicated by mean GSQ score. Discussion Extra-pulmonary symptoms were common in this sample of people with severe asthma. Extra-pulmonary and pulmonary symptoms provided equal variance to the score of HRQoL, suggesting that they are equally important contributors to patient’s experience of severe asthma. Despite this, extra-pulmonary symptoms are often overlooked in clinical medicine and in measures of quality of life. Participants receiving biologic treatments had lower extra-pulmonary symptoms possibly indicating that biologics reduce systemic symptoms more effectively than other treatments.