Prevalence of chronic obstructive pulmonary disease (COPD) among rheumatoid arthritis: results from national inpatient database

Abstract

Rheumatoid arthritis (RA) is being increasingly recognized as an important contributor to chronic obstructive pulmonary disease (COPD). Although smoking is a major risk factor, other factors may play a role. We used National Inpatient Sample (NIS) from 2013 to explore this relationship. We used propensity matching with a 1:3 nearest-neighbor-matching algorithm to match 1 RA hospitalization to 3 age- and-sex-matched comparators. In the age- and-sex-matched population, RA had a higher odds of COPD (OR 1.20, 95% CI: 1.17–1.22, p < 0.0001).RA is associated with increased COPD prevalence, independent of smoking. COPD might fall within the spectrum of RA complications, likely due to autoimmune and inflammatory mechanisms.

Elevated Anti–Citrullinated Protein Antibodies Prior to Rheumatoid Arthritis Diagnosis and Risks for Chronic Obstructive Pulmonary Disease or Asthma

“…A meta-analysis found that RA increased COPD risk with a relative risk of 1.99 (95% CI 1.61-2.45) (20). Case-control studies found an association between RA and COPD (14,15,17) but did not investigate by ACPA status and did not adjust for smoking, a strong risk factor for both diseases as well as ACPA positivity (14,15,17). A population-based cohort study in British Columbia, as well as several retrospective cohorts, similarly found associations between RA and COPD but lacked data on serologic status (16,18,21,24).…”

“…Ours is the first to study elevation of ACPA in the pre‐RA period and risk for chronic airways diseases, but prior studies have suggested that patients with RA have an increased risk of subsequent COPD development compared to non‐RA controls (13–25). A meta‐analysis found that RA increased COPD risk with a relative risk of 1.99 (95% CI 1.61–2.45) (20).…”

“…Prior studies have demonstrated a relationship between RA and subsequent COPD risk (13–25). Several case–control studies and retrospective cohorts were limited by the inability to investigate serologic status (18,22) or account for smoking (14–17,21,24), a strong risk factor for both COPD and RA. Some studies found that this association is more pronounced in seropositive RA (13,25) and independent of smoking (13,18,22).…”

<p>A Genome-Wide Association Study in Early COPD: Identification of One Major Susceptibility Loci</p>

“…Autoimmunity may contribute to COPD pathogenesis since COPD occurs among never smokers and, more frequently, in patients with rheumatoid arthritis. 19 The HLA molecules, particularly HLA class II, are associated with autoimmune diseases, for example, type 1 diabetes and systemic lupus erythematous. 20 This study, therefore, raises the possibility of an association between COPD and HLA class II, mainly HLA-DQ.…”

Trends in Prevalence and Outcomes of Cannabis Use Among Chronic Obstructive Pulmonary Disease Hospitalizations: A Nationwide Population-Based Study 2005–2014

“…A description of the National Inpatient Sample (NIS) database has been elaborated in prior studies. 4,[18][19][20] The NIS is one of the largest, all-payer publicly available in-patient care database for the United States and is maintained by the Agency for Health Care Quality and Research (AHRQ). 21 The NIS includes a 20% stratified random sample of all in-patient hospitalizations from 46 states in the United States and contains information on over 7 million hospital discharges per year.…”