Chronic airway inflammation may be crucial in the pathogenesis of rheumatoid arthritis (RA), according to the results of a prospective cohort study published in Arthritis & Rheumatology.

Pulmonary inflammation has been implicated in the pathogenesis of RA, but whether diseases of chronic airway inflammation increase the risk of developing RA is unclear. Thus, researchers performed a prospective cohort study in 205,153 women in the Nurses’ Health Study and Nurses’ Health Study II. A total of 15,148 women with confirmed asthma, 3573 women with confirmed chronic obstructive pulmonary disease (COPD), and 1060 incident RA cases during 4,384,471 person-years of follow-up were included.

The researchers found that asthma was associated with a >50%  increase in the risk of subsequent RA compared with no asthma/COPD, independent of potential confounders, most notably smoking status and duration/intensity. COPD conferred a nearly 90% increased risk of developing RA compared with no asthma/COPD in this cohort after multivariable adjustment including adjustment for smoking. In particular, there was a >2-fold increased risk of RA in smokers older than 55 years.

These findings identify asthma and COPD as risk factors for the development of rheumatoid arthritis; however, 2 of the limitations of this study were that it was conducted only in women and the majority of participants were white.


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The researchers concluded, “These novel findings further implicate chronic airway inflammation in the pathogenesis of RA, and they identify populations at-risk for RA for the purposes of research as well as informing clinical care.” They added that, “Providers caring for patients with asthma or COPD should be aware of increased RA risk in these populations and have a low threshold to evaluate for RA in asthma or COPD patients with inflammatory joint symptoms.”

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Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Ford JA, Liu X, Chu SH, et al. Asthma, chronic obstructive pulmonary disease, and subsequent risk for incident rheumatoid arthritis among women: A prospective cohort study. Arthritis Rheumatol. doi:10.1002/art.41194