Table 1.
Summary of prior studies investigating the association between rheumatoid arthritis and obstructive lung diseases.
| First author (Year) (Reference) | Study design | Population Number of cases /comparators | RA method of identification | Outcome; method of identification | Smoking adjustment | Results | Comments |
|---|---|---|---|---|---|---|---|
| COPD | |||||||
| Hemminki (2011) (47) | Retrospective cohort | Sweden Not reported | Billing code | COPD; billing code | No | SIR 2.57 (95% CI 2.21–2.99) | Evaluated many autoimmune diseases for risk of COPD/lung cancer; observed results compared to expected number by socioeconomic strata |
| Nannini (2013) (19) | Retrospective cohort | USA, Olmsted County, Minnesota 594 RA/596 matched comparators | 1987 ACR criteria | Obstructive lung disease*; clinical testing/physician diagnosis | Yes; never/past/current at baseline | HR 1.54 (95% CI 1.01–2.34) | Incident RA matched to comparators by age and sex; also adjusted for alcoholism; subset of non-smokers had HR of 1.98 (95% CI 0.73–5.40); rheumatoid factor positivity had increased risk |
| Ursum (2013) (48) | Retrospective cohort | Netherlands 3,356 RA/6,708 matched controls | Billing code for “Inflammatory arthritis” | COPD; billing code | No | HR 1.8 (95% CI 1.4–2.3) | Incident inflammatory arthritis matched to controls by age and sex; other comorbid disorders also investigated |
| Shen (2014) (17) | Retrospective cohort | Taiwan 28,725 RA/114,900 matched comparators | Billing code | COPD; billing code | No | HR 1.85 (95% CI 1.70–2.01) | Adjusted for age, sex, and comorbidities |
| Ungprasert (2016) (16) | Meta-analysis | - | - | COPD | - | RR 1.99 (1.61–2.45) | Meta-analyzed results of 4 studies (references 17, 19, 47, 48) |
| Doss (2017) (41) | Phenome-wide association study | USA, Vanderbilt University Medical Center 2,199 RA (1,382 seropositive vs. 817 seronegative) | Electronic medical record algorithm | Chronic airway obstruction; billing code | No | Seropositive RA: OR 2.2 (95% CI 1.5–3.4) vs. seronegative RA | Hypothesis-generating study comparing disease associations in seropositive vs. seronegative RA |
|
| |||||||
| Asthma | |||||||
| Ursum (2013) (48) | Retrospective cohort | Netherlands 3,356 RA/6,708 matched controls | Billing code for “Inflammatory arthritis” | Asthma; billing code | No | HR 1.4 (95% CI 1.1–1.8) | Incident inflammatory arthritis matched to controls by age and sex; other comorbid disorders also investigated |
| Shen (2014) (18) | Retrospective cohort | Taiwan 27,602 RA/82,806 matched comparators | Billing code | Asthma; billing code | No | HR 2.07 (95% CI 1.89–2.26) | Adjusted for age, sex, and comorbidities |
| Lai (2015) (49) | Retrospective cohort | Taiwan 170,570 patients with allergic diseases/170,238 matched comparators | Billing code | Incident RA; billing code | No | Asthma: HR 1.67 (95% CI 1.32–2.62) for incident RA vs. no asthma | Exposures were asthma, allergic rhinitis, and atopic dermatitis; incident RA was the outcome; allergic rhinitis was also associated with RA (HR 1.62, 95% CI 1.33–1.98) |
*
Obstructive lung disease was a composite outcome comprised of COPD, asthma, bronchiectasis, and interstitial lung disease. The majority of cases were COPD.
ACR, American College of Rheumatology; CI, confidence interval; COPD, chronic obstructive lung disease; HR, hazard ratio; OR, odds ratio; RA, rheumatoid arthritis; RR, risk ratio; SIR, standardized incidence ratio.