Increased risk of bronchiectasis observed in individuals with rheumatoid arthritis

In a recent study published in the journal of CHEST analyzed the coexistence of bronchiectasis and rheumatoid arthritis (RA) by revealing that individuals with RA face a two-fold higher risk of developing bronchiectasis when compared to individuals without this inflammatory joint disorder.

The study was conducted with a group of 50,651 individuals with RA (35,879 seropositive RA [SPRA] and 14,772 seronegative RA [SNRA]) with carefully matched control group of 253,255 participants to investigate the relationship between RA and bronchiectasis.

Over a median follow-up period of 4.3 years the individuals with RA exhibited a cumulative incidence of bronchiectasis at approximately 7%, which prompts a concern about the intricate interplay between these conditions.

After meticulous adjustment for potential confounders related to bronchiectasis this research unveiled that participants with RA bore a 2.12-fold higher risk of developing bronchiectasis when compared to their matched counterparts (95% confidence interval [CI], 2.00–2.25). This suggests that beyond the shared risk factors, rheumatoid arthritis itself contributes to the increased susceptibility to bronchiectasis.

An in depth analysis into the serologic status of RA within the study highlighted an intensified risk associated with seropositive RA. The participants with SPRA underwent a remarkable 2.34-fold increase in the risk of bronchiectasis (95% CI, 2.20–2.49) by underlining the profound impact of rheumatic inflammation in the development of this pulmonary condition. Also, the individuals with seronegative RA still exhibited a 1.56-fold elevated risk (95% CI, 1.40–1.73) and emphasized the critical relationship between RA and bronchiectasis regardless of serologic status.

In conclusion, this study unravels the previously unexplored dimension of RA's impact but also underline the need for heightened clinical awareness regarding the respiratory risks in individuals with RA. 

Source:

Choi, H., Han, K., Jung, J. H., Park, J., Kim, B.-G., Yang, B., Eun, Y., Kim, H., Shin, D. W., & Lee, H. (2024). Impact of Rheumatoid Arthritis and Seropositivity on the Risk of Non–Cystic Fibrosis Bronchiectasis. In CHEST. Elsevier BV. https://doi.org/10.1016/j.chest.2024.01.001