Risk of Rheumatoid Arthritis in Patients With Obstructive Lung Disease

Abstract

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting the joints with extra-articular manifestation. The current literature has suggested an increased risk of RA among patients with obstructive pulmonary disease; thus, both conditions have common risk factors, including tobacco use and obesity. Describing this relationship would help to assess obstructive pulmonary disease risk among patients with RA for early intervention and establish pulmonary rehabilitation and self-management education programs. However, the evidence regarding this association is still obscure. The current study aimed to assess the association between obstructive pulmonary disease and RA in a hospital-based case-control study.

Methods: A matched case-control study was performed utilizing the electronic database from tertiary care center in Saudi Arabia between 2016 and 2020. Adult patients who have been diagnosed with RA were matched on age and gender to control patients without RA. Data on the obstructive pulmonary disease were assessed before the date of RA diagnosis, including asthma, chronic obstructive pulmonary disease, chronic bronchitis, emphysema, and bronchiectasis. In addition to other data related to lifestyles and other comorbidities were collected. Logistic regression models were used to compare study groups.

Results: The study included 304 RA cases and 1,182 controls. The mean age was 48 ± 16 for both cases and controls, with 50% female patients. The prevalence of obstructive pulmonary disease was higher in cases compared to control [11.8% vs. 7.4% %, P< 0.013, odds ratio (OR) 1.67, 95% CI 1.11-2.52]. After controlling for confounders, including smoking, obesity, and comorbidities, the adjusted OR was 1.37 (95% CI 0.83–2.27).

Conclusions: In this case-control study, RA was found to be associated with obstructive pulmonary disease. From a clinical point, both obstructive pulmonary disease and RA reduce mobility; therefore, respiratory therapists need to be aware of their concurrence to start early management programs such as pulmonary rehabilitation and smoking cessation.