COPD and Asthma linked to rheumatoid arthritis in new study

US: Inflamed airways are hypothesized to contribute to rheumatoid arthritis (RA) pathogenesis due to RA‐related autoantibody production, and smoking is the strongest environmental RA risk factor. However, the association of asthma and COPD with rheumatoid arthritis is still unclear.

To uncover this, Dr. Julia Ford and his colleagues from Brigham and Women's Hospital performed a prospective cohort study that was published in the journal Arthritis and Rheumatology. The findings of the study suggested that chronic airway inflammation could be crucial in rheumatoid arthritis pathogenesis.

The prospective cohort study which included 205,153 women in the Nurses' Health Study (NHS, 1988‐2014) and NHSII (1991‐2015) were self‐reported physician‐diagnosed asthma or COPD confirmed by validated supplemental questionnaires about lifestyle; health behaviors; medications; and diseases. Outcomes were incident RA confirmed by medical record review by 2 rheumatologists. Covariates (including smoking pack‐years/status) were assessed via biennial questionnaires. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for RA were estimated using Cox regression.

The investigators identified 15,148 women with confirmed asthma, 3573 women with confirmed COPD, and 1060 incident rheumatoid arthritis cases (63% seropositive). The multivariable-adjusted HR for developing rheumatoid arthritis was 1.53 among women with asthma compared to those without asthma or COPD. Further, asthma was linked to seropositive and seronegative rheumatoid arthritis.

Following are the key findings,

 Asthma was associated with all rheumatoid arthritis among never-smokers and seronegative rheumatoid arthritis, but not with seropositive rheumatoid arthritis.

 For ever-smokers, asthma had HRs for all rheumatoid arthritis of 1.49 for seropositive rheumatoid arthritis and for seronegative rheumatoid arthritis of 1.48

 Rheumatoid arthritis risk was significantly increased in prevalent asthma and incident asthma.

 The HR for developing rheumatoid arthritis was 1.89 among women with COPD compared to those without COPD or asthma.

Thus the study concluded that asthma and COPD were each associated with increased risk for incident RA, independent of smoking status/intensity and other potential confounders. These results provide support for the hypothesis that chronic airway inflammation may be crucial in RA pathogenesis.

For further reading click on the following link,

https://doi.org/10.1002/art.41194