COPD and Rheumatoid Arthritis: Results of Nurses’ Health Study

Increased Risk of COPD and Rheumatoid Arthritis

Background:

Rheumatoid arthritis is a chronic inflammatory condition that is considered an autoimmune disorder. This means that the body’s immune system mistakenly attacks the body’s own tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

Images of inflammed joints suggesting a relationship between COPD and rheumatoid arthritis

Images of a normal joint and of osteoarthritis and rheumatoid arthritis

In some people, rheumatoid arthritis can also damage the skin, eyes, lungs, heart and blood vessels. As both COPD and rheumatoid arthritis are inflammatory conditions, it is interesting to consider whether COPD is more common in those with rheumatoid arthritis.

Study:

Dr. Jeffrey Sparks and colleagues at Brigham and Women’s Hospital in Boston used information (medical records and results of questionnaires completed every two years) collected between 1976 and 2014 in 121,701 women as part of the Nurses’ Health Study. For every woman with rheumatoid arthritis, they found 10 other women who did not have this condition but the same age. The study was published online on September 5, 2017, in Seminars in Arthritis & Rheumatism.

Results:

There were 843 women with rheumatoid arthritis matched with 8,399 women without this condition. Average age was 60 years. Rheumatoid arthritis was associated with a 52% increased risk of COPD.

Conclusion:

Rheumatoid arthritis was associated with increased risk for COPD independent of cigarette smoking.

My Comments:

If you have rheumatoid arthritis and have shortness of breath with activities, you should mention this to your health care professional at your next appointment. You should ask that breathing tests be ordered.

Why? Based on the results of this study, it is possible that you have COPD even if you did not smoke. Another possibility is inflammation and scarring the lung tissue called interstitial lung disease – which can also occur in those with rheumatoid arthritis.

COPD involves the breathing tubes (airways) of the lungs while interstitial lung disease involves the supporting tissues, or walls, of the air sacs.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.