3 years ago

Risk of Incident Chronic Obstructive Pulmonary Disease (COPD) in Rheumatoid Arthritis: A Population Based Cohort Study

Eric C. Sayre, Mohsen Sadatsafavi, Katherine McGuire, Michal Abrahamowicz, J.Antonio Avina-Zubieta, Diane Lacaille, John M. Esdaile
Objective Studies have demonstrated a link between COPD and inflammation, raising the question whether chronic inflammatory conditions, such as RA, predispose to COPD. Our objective was to evaluate the risk of incident COPD hospitalization in RA compared to the general population. Methods We studied a population-based incident RA cohort with matched general population controls, using administrative health data.. All incident RA cases in British Columbia (BC) who first met RA definition between 01/1996 and 12/2006 were selected using previously published criteria. General population controls were randomly selected, matched 1:1 to RA cases on birth year, sex, and index year. COPD outcome was defined as hospitalization with a primary COPD code. Incidence rates, 95% Cis, and incidence rate ratios (IRR) were calculated for RA and controls. Multivariable Cox proportional hazard models (PHM) estimated the risk of COPD in RA compared to the general population after adjusting for potential confounders. Sensitivity analyses were performed to test the robustness of the results to the possible confounding effect of smoking, unavailable in administrative data, and to COPD outcome definitions. Results The cohorts included 24,625 RA individuals and 25,396 controls. The incidence of COPD hospitalization was greater in RA than controls [IRR (95%CI):1.58(1.34;1.87)]. After adjusting for potential confounders, RA cases had a 47% greater risk of COPD hospitalization than controls. The increased risk remained significant after modelling for smoking and with varying COPD definitions. Conclusion In our population-based cohort, individuals with RA had a 47% greater risk of COPD hospitalization compared to the general population. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/acr.23410

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