Rheumatoid arthritis associated with risk of COPD, study finds

Rheumatoid arthritis (RA) was associated with an increased risk of chronic obstructive pulmonary disease (COPD), and the risk was higher with seropositive RA, a Korean study found.

Researchers used the Korean National Health Insurance Database to assess rates of COPD in people diagnosed with RA from 2010 to 2017. Overall, 46,030 patients with RA (32,608 seropositive RA and 13,422 seronegative RA) were matched 1:10 by sex, age as a continuous variable, and index year with a control group of people without RA (n=276,180) and monitored through December 2019. Results of the study were published Feb. 16 by CHEST.

A total of 3,374 new COPD cases (2,335 in the control group and 1,039 in the RA group) developed during a median of 4.5 years of follow-up. Incidence rates of COPD were 2.23 per 1,000 person-years in the control group, 5.04 per 1,000 person-years among all patients with RA, 5.41 per 1,000 person-years for seropositive RA, and 4.14 per 1,000 person-years for seronegative RA.

After adjustment, patients with RA had a significantly higher risk for COPD (adjusted hazard ratio [aHR], 2.11; 95% CI, 1.96 to 2.28) compared with the control group. While both seropositive RA and seronegative RA were associated with COPD risk, patients with seropositive RA had a significant increase in risk compared with patients with seronegative RA (aHR, 1.26; 95% CI, 1.09 to 1.46). A history of smoking did not affect the interaction between RA and COPD.

Based on these results, clinicians should monitor respiratory symptoms and pulmonary function carefully in patients with RA, the study authors said. "Given the chronic and systemic nature of RA as an inflammatory disease, there seems to be a link between autoimmune processes in these two conditions," they wrote. "Such a link may contribute to an elevated risk of developing COPD among individuals with RA."