The risk is nearly twice as high as in the general population, and women are at significantly higher risk.
The risk of being hospitalized for chronic obstructive pulmonary disease (COPD) is nearly twice as high in patients with rheumatoid arthritis when compared with the general population.
In particular, women with rheumatoid arthritis are at significantly higher risk for being hospitalized for COPD.
COPD is known to be linked to inflammation, noted Katherine McGuire and fellow researchers in Canada, and they pointed out that many of the same markers of inflammation found in rheumatoid arthritis are elevated in COPD.
Investigation to determine the impact of rheumatoid arthritis on the incidence of COPD has been limited. The authors sought to evaluate the risk of COPD in rheumatoid arthritis and presented their findings in a recent Arthritis Care & Research article.
They conducted a retrospective, population-based cohort study to examine the incidence of COPD in patients with rheumatoid arthritis. Ultimately, 24,625 patients with rheumatoid arthritis and 25,396 controls were included in the analysis.
• Subjects with rheumatoid arthritis were more likely than controls to be hospitalized for COPD, with incidences per 1000 patient-years of 2.07 and 1.31, respectively (relative risk, 1.58; 95% confidence interval [CI], 1.34-1.87).
• When adjusted for gender, the risk of COPD in women with rheumatoid arthritis was significantly increased (hazard ratio, 1.61; 95% CI, 1.30-1.98).
• When the model was adjusted for a confounding effect with smoking, the risk of COPD remained significant.
Implications for physicians
• Physicians should be aware that the risk of being hospitalized for COPD is 47% higher in patients with rheumatoid arthritis than in persons in the general population.
• Women with rheumatoid arthritis are at particularly high risk for hospitalization for COPD (61% increase).
• Smoking does not appear to be responsible for the increase in risk.
• Physicians should strive to control inflammation in patients with rheumatoid arthritis effectively, not only to prevent joint damage and alleviate symptoms but also to lessen potential comorbidities, such as COPD.
• Physicians should emphasize lifestyle modifications, such as smoking cessation, when they counsel patients with rheumatoid arthritis because of their impact on cardiovascular and pulmonary health.
This study was funded by the Canadian Institute for Health Research.
McGuire K, Avina-Zubieta JA, Esdaile JM, et al. “Risk of Incident Chronic Obstructive Pulmonary Disease (COPD) in Rheumatoid Arthritis: A Population Based Cohort Study.” Arthritis Care Res (Hoboken). 2017 Oct 19. doi: 10.1002/acr.23410. [Epub ahead of print]