| Title: | Rheumatoid arthritis and changes on spirometry by smoking status in two prospective longitudinal cohorts |
| Journal: | RMD Open |
| Published: | 17 Jun 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/38886003/ |
| DOI: | https://doi.org/10.1136/rmdopen-2024-004281 |
| URL: | https://rmdopen.bmj.com/content/rmdopen/10/2/e004281.full.pdf |
Publication 11845
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Abstract
OBJECTIVE: To compare longitudinal changes in spirometric measures between patients with rheumatoid arthritis (RA) and non-RA comparators.</p>
METHODS: We analysed longitudinal data from two prospective cohorts: the UK Biobank and COPDGene. Spirometry was conducted at baseline and a second visit after 5-7 years. RA was identified based on self-report and disease-modifying antirheumatic drug use; non-RA comparators reported neither. The primary outcomes were annual changes in the per cent-predicted forced expiratory volume in 1 s (FEV1%) and per cent predicted forced vital capacity (FVC%). Statistical comparisons were performed using multivariable linear regression. The analysis was stratified based on baseline smoking status and the presence of obstructive pattern (FEV1/FVC <0.7).</p>
RESULTS: Among participants who underwent baseline and follow-up spirometry, we identified 233 patients with RA and 37 735 non-RA comparators. Among never-smoking participants without an obstructive pattern, RA was significantly associated with more FEV1% decline (β=-0.49, p=0.04). However, in ever smokers with ≥10 pack-years, those with RA exhibited significantly less FEV1% decline than non-RA comparators (β=0.50, p=0.02). This difference was more pronounced among those with an obstructive pattern at baseline (β=1.12, p=0.01). Results were similar for FEV1/FVC decline. No difference was observed in the annual FVC% change in RA versus non-RA.</p>
CONCLUSIONS: Smokers with RA, especially those with baseline obstructive spirometric patterns, experienced lower FEV1% and FEV1/FVC decline than non-RA comparators. Conversely, never smokers with RA had more FEV1% decline than non-RA comparators. Future studies should investigate potential treatments and the pathogenesis of obstructive lung diseases in smokers with RA.</p>
15 Keywords
- Adult
- Aged
- Arthritis, Rheumatoid
- Female
- Forced Expiratory Volume
- Humans
- Longitudinal Studies
- Male
- Middle Aged
- Prospective Studies
- Pulmonary Disease, Chronic Obstructive
- Smoking
- Spirometry
- United Kingdom
- Vital Capacity
20 Authors
- Keigo Hayashi
- Gregory C McDermott
- Pierre-Antoine Juge
- Matthew Moll
- Michael H Cho
- Xiaosong Wang
- Misti L Paudel
- Tracy J Doyle
- Gregory L Kinney
- Danielle Sansone-Poe
- Kendra Young
- Paul F Dellaripa
- Zachary S Wallace
- Elizabeth A Regan
- Gary M Hunninghake
- Edwin K Silverman
- Samuel Y Ash
- Raul San Jose Estepar
- George R Washko
- Jeffrey A Sparks
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