연구성과 홍보

Chest. 2024 Jun;165(6):1362-1371.

Title : Does Rheumatoid Arthritis Increase the Risk of COPD?: A Nationwide Retrospective Cohort Study

Authors : Chiwook Chung1, Hyungjin Kim2, Kyungdo Han3, Jinhyoung Jung4, Yeonghee Eun5, Hyun Lee6, Junhee Park7, Dong Wook Shin8, Sei Won Lee9*

Affiliations :

1Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung.

2Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Medical Humanites, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.

3Department of Statistics and Actuarial Science, Soongsil University, Seoul.

4Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul.

5Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul.

6Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul.

7Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.

8Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul.

9Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

DOI: 10.1016/j.chest.2024.02.014.

Abstract :

Background: Most reports of pulmonary manifestations in rheumatoid arthritis (RA) have been related to interstitial lung diseases. RA and COPD are both chronic inflammatory systemic diseases.

Research question: Does RA increase the risk of developing COPD? Is there a difference between seropositive and seronegative RA in the risk of COPD?

Study design and methods: Using the Korean National Health Insurance Database, we screened individuals diagnosed with RA between 2010 and 2017. We identified 46,030 patients with RA (32,608 with seropositive RA and 13,422 with seronegative RA) and 230,150 matched control individuals; we monitored them until December 2019. We used multivariate Cox proportional hazard models to estimate the adjusted hazard ratio (aHR) of risk factors for the development of COPD.

Results: The incidence of COPD among patients with RA was 5.04 per 1,000 person-years; it was 2.23 per 1,000 person-years in the control group. Patients with RA showed a higher risk of developing COPD (aHR, 2.11; 95% CI, 1.96-2.28) compared with the control group. Although both seropositive RA and seronegative RA were associated with an increased risk of COPD, patients with seropositive RA had a higher risk for the development of COPD (aHR, 1.26; 95% CI, 1.09-1.46) than patients with seronegative RA. In the subgroup analyses, smoking history did not demonstrate significant interactions between RA and COPD development.

Interpretation: RA was shown to be associated with an increased risk of COPD development, augmented by seropositivity. Physicians should monitor respiratory symptoms and pulmonary function carefully in patients with RA.