Rheumatoid Arthritis and COPD

By Jane Farrell

People suffering from rheumatoid arthritis may be at increased risk for developing chronic obstructive pulmonary disease (COPD), according to new research.

The findings were published in the journal Arthritis Care & Research. The authors said increased attention may be needed to protect the respiratory health of people with chronic inflammatory conditions.

Research has demonstrated an association between COPD – a progressive disease that affects the lungs – and inflammation, raising the question of whether prolonged inflammatory conditions such as rheumatoid arthritis predispose individuals to COPD. To investigate, a team led by Diane Lacaille, MD, FRCPC, MHSc, of Arthritis Research Canada and the University of British Columbia, examined information on individuals in the province of British Columbia who were diagnosed with rheumatoid arthritis between 1996 and 2006, and compared it with information on matched individuals in the general population. The analysis included 24,625 patients with rheumatoid arthritis and 25,396 controls.

The investigators found that the incidence of COPD hospitalization was greater in patients with rheumatoid arthritis than in the general population. After adjusting for potential confounding factors, individuals with rheumatoid arthritis had a 47% greater risk of needing to be hospitalized for COPD than controls. The increased risk remained significant after factoring in smoking and with varying COPD definitions.

“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,” Lacaille said. “Our results emphasize the need to control inflammation, and in fact to aim for complete eradication of inflammation through effective treatment of rheumatoid arthritis.”

Lacaille added that clinicians and people living with rheumatoid arthritis should be vigilant in watching for early symptoms of COPD. “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.” Such steps will improve long-term outcomes for patients and reduce the costs of COPD. The study also points to the need to address COPD risk factors such as smoking in people living with rheumatoid arthritis.