Study Finds a 47% Increased Risk of COPD Hospitalization Among RA Patients

Previous studies have revealed a potential connection between chronic inflammatory conditions and the predisposition of chronic obstructive pulmonary disease (COPD), and a new study has found that patients with rheumatoid arthritis (RA) are associated with a greater risk of COPD hospitalization compared to the general population.

In a study published by Arthritis Care & Research, researchers utilized administrative health data to match an incident RA cohort with general population controls. All RA cases that were included were in British Columbia and the participants had RA between January 1996 and December 2006. The controls were then randomly selected and matched to RA cases based on birth year, sex, and index year.

The researchers compared the 2 groups through incidence rate ratios, and the use of multivariable Cox proportional hazard models to estimate the risk of COPD. Additionally, sensitivity analyses were conducted to consider the potential confounding effect of smoking.

Of the 24,625 RA patients and 25,396 controls, the incidence of COPD hospitalization was higher in the RA group. Following the adjustment for confounders, patients with RA were found to have a 47% greater risk of COPD hospitalization than the controls. This increased risk was also significant aftering modelling for smoking.

“These findings are novel because it has only recently been recognized that inflammation plays a role in the development of COPD, and clinicians treating people with rheumatoid arthritis are not aware that their patients are at increased risk of developing COPD,” Diane Lacaille, MD, FRCPC, MHSc, of Arthritis Research Canada and the University of British Columbia, said in a statement. “Our results emphasize the need to control inflammation, and in fact to aim for complete eradication of inflammation through effective treatment of rheumatoid arthritis.”

Dr Lacaille also noted that clinicians and those who live with RA should be aware of the early symptoms of COPD; by doing so, long-term outcomes may improve and the costs of COPD could decrease.

“That way, appropriate tests can be administered to diagnose COPD early, at the onset of symptoms, so that effective treatments for COPD can be initiated before irreversible damage to the lungs occurs," Lacaille said.

The study also suggests that COPD risk factors, such as smoking, should be addressed by those who live with RA due to this increased risk of hospitalization.