Rheumatoid Arthritis and Changes on Spirometry by Smoking Status in Two Prospective Longitudinal Cohorts

Overview

Journal RMD Open

Publisher BMJ Publishing Group

Specialty Rheumatology

Date 2024 Jun 17

PMID 38886003

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

Affiliations

Soon will be listed here.

Abstract

Objective: To compare longitudinal changes in spirometric measures between patients with rheumatoid arthritis (RA) and non-RA comparators.

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 (FEV%) 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 (FEV/FVC <0.7).

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 FEV% decline (β=-0.49, p=0.04). However, in ever smokers with ≥10 pack-years, those with RA exhibited significantly less FEV% 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 FEV/FVC decline. No difference was observed in the annual FVC% change in RA versus non-RA.

Conclusions: Smokers with RA, especially those with baseline obstructive spirometric patterns, experienced lower FEV% and FEV/FVC decline than non-RA comparators. Conversely, never smokers with RA had more FEV% decline than non-RA comparators. Future studies should investigate potential treatments and the pathogenesis of obstructive lung diseases in smokers with RA.

References

Hyland R, Gordon D, BRODER I, Davies G, Russell M, Hutcheon M . A systematic controlled study of pulmonary abnormalities in rheumatoid arthritis. J Rheumatol. 1983; 10(3):395-405. View

Reynisdottir G, Olsen H, Joshua V, Engstrom M, Forsslund H, Karimi R . Signs of immune activation and local inflammation are present in the bronchial tissue of patients with untreated early rheumatoid arthritis. Ann Rheum Dis. 2015; 75(9):1722-7. DOI: 10.1136/annrheumdis-2015-208216. View

Castro M, Corren J, Pavord I, Maspero J, Wenzel S, Rabe K . Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. N Engl J Med. 2018; 378(26):2486-2496. DOI: 10.1056/NEJMoa1804092. View

Ramos-Remus C, Castillo-Ortiz J, Aguilar-Lozano L, Padilla-Ibarra J, Sandoval-Castro C, Vargas-Serafin C . Autoantibodies in prediction of the development of rheumatoid arthritis among healthy relatives of patients with the disease. Arthritis Rheumatol. 2015; 67(11):2837-44. DOI: 10.1002/art.39297. View

Garudadri S, Woodruff P . Targeting Chronic Obstructive Pulmonary Disease Phenotypes, Endotypes, and Biomarkers. Ann Am Thorac Soc. 2019; 15(Suppl 4):S234-S238. PMC: 6321999. DOI: 10.1513/AnnalsATS.201808-533MG. View

McDermott G, Hayashi K, Yoshida K, Moll M, Cho M, Doyle T . Prevalence and mortality associations of interstitial lung abnormalities in rheumatoid arthritis within a multicentre prospective cohort of smokers. Rheumatology (Oxford). 2023; 62(SI3):SI286-SI295. PMC: 10593512. DOI: 10.1093/rheumatology/kead277. View

Sparks J, Jin Y, Cho S, Vine S, Desai R, Doyle T . Prevalence, incidence and cause-specific mortality of rheumatoid arthritis-associated interstitial lung disease among older rheumatoid arthritis patients. Rheumatology (Oxford). 2021; 60(8):3689-3698. PMC: 8328504. DOI: 10.1093/rheumatology/keaa836. View

Regan E, Hokanson J, Murphy J, Make B, Lynch D, Beaty T . Genetic epidemiology of COPD (COPDGene) study design. COPD. 2010; 7(1):32-43. PMC: 2924193. DOI: 10.3109/15412550903499522. View

Bowerman C, Bhakta N, Brazzale D, Cooper B, Cooper J, Gochicoa-Rangel L . A Race-neutral Approach to the Interpretation of Lung Function Measurements. Am J Respir Crit Care Med. 2022; 207(6):768-774. DOI: 10.1164/rccm.202205-0963OC. View

10.

Prisco L, Moll M, Wang J, Hobbs B, Huang W, Martin L . Relationship Between Rheumatoid Arthritis and Pulmonary Function Measures on Spirometry in the UK Biobank. Arthritis Rheumatol. 2021; 73(11):1994-2002. PMC: 8568623. DOI: 10.1002/art.41791. View

11.

Bergsoe C, Sivapalan P, Saeed M, Eklof J, Saghir Z, Sorensen R . Risk of Chronic Obstructive Pulmonary Disease Exacerbation in Patients Who Use Methotrexate-A Nationwide Study of 58,580 Outpatients. Biomedicines. 2021; 9(6). PMC: 8229017. DOI: 10.3390/biomedicines9060604. View

12.

Raimundo K, Solomon J, Olson A, Kong A, Cole A, Fischer A . Rheumatoid Arthritis-Interstitial Lung Disease in the United States: Prevalence, Incidence, and Healthcare Costs and Mortality. J Rheumatol. 2018; 46(4):360-369. DOI: 10.3899/jrheum.171315. View

13.

Silosi I, Boldeanu M, Cojocaru M, Biciusca V, Padureanu V, Bogdan M . The Relationship of Cytokines IL-13 and IL-17 with Autoantibodies Profile in Early Rheumatoid Arthritis. J Immunol Res. 2016; 2016:3109135. PMC: 4989068. DOI: 10.1155/2016/3109135. View

14.

Raza K, Falciani F, Curnow S, Ross E, Lee C, Akbar A . Early rheumatoid arthritis is characterized by a distinct and transient synovial fluid cytokine profile of T cell and stromal cell origin. Arthritis Res Ther. 2005; 7(4):R784-95. PMC: 1175027. DOI: 10.1186/ar1733. View

15.

Moffett A, Bowerman C, Stanojevic S, Eneanya N, Halpern S, Weissman G . Global, Race-Neutral Reference Equations and Pulmonary Function Test Interpretation. JAMA Netw Open. 2023; 6(6):e2316174. PMC: 10236239. DOI: 10.1001/jamanetworkopen.2023.16174. View

16.

Woods J, Haines G, Shah M, Rayan G, Koch A . Low-level production of interleukin-13 in synovial fluid and tissue from patients with arthritis. Clin Immunol Immunopathol. 1997; 85(2):210-20. DOI: 10.1006/clin.1997.4441. View

17.

McDermott G, Hayashi K, Yoshida K, Juge P, Moll M, Cho M . Rheumatoid arthritis, quantitative parenchymal lung features and mortality among smokers. Rheumatology (Oxford). 2023; 64(1):133-142. PMC: 11701304. DOI: 10.1093/rheumatology/kead645. View

18.

Demoruelle M, Weisman M, Simonian P, Lynch D, Sachs P, Pedraza I . Brief report: airways abnormalities and rheumatoid arthritis-related autoantibodies in subjects without arthritis: early injury or initiating site of autoimmunity?. Arthritis Rheum. 2011; 64(6):1756-61. PMC: 3319006. DOI: 10.1002/art.34344. View

19.

Hyldgaard C, Hilberg O, Pedersen A, Ulrichsen S, Lokke A, Bendstrup E . A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: comorbidity and mortality. Ann Rheum Dis. 2017; 76(10):1700-1706. DOI: 10.1136/annrheumdis-2017-211138. View

20.

Gour N, Wills-Karp M . IL-4 and IL-13 signaling in allergic airway disease. Cytokine. 2015; 75(1):68-78. PMC: 4532591. DOI: 10.1016/j.cyto.2015.05.014. View