Women with rheumatoid arthritis were 68 percent likelier to develop chronic obstructive pulmonary disease (COPD) than was the general population. That’s a conclusion researchers came to after accounting for differences in lifestyle, including smoking, diet, and physical activity.

“Clinicians should have a low threshold to evaluate for airway abnormalities in patients with respiratory symptoms,” says the Seminars in Arthritis & Rheumatism study lead author Jeffrey Sparks, assistant professor of medicine at Harvard Medical School and a rheumatologist at Brigham and Women’s Hospital.

A chronic, inflammatory lung disease, COPD obstructs airflow to the lung, and its symptoms include difficulty breathing, coughing, and wheezing and mucus production, according to the Mayo Clinic. Cigarette smoke is the most frequent cause, the clinic adds.

Prior studies had also demonstrated a connection between rheumatoid arthritis and chronic obstructive pulmonary disease, but they failed to distinguish between what might relate to lifestyle factors, like smoking, which are common in RA and the COPD disease itself.

“We were able to evaluate for the autoantibodies on COPD risk and found that patients with RA that have autoantibodies were more likely to develop COPD,” Sparks says.

Sparks and colleagues identified 843 women with RA from among the 121,701 women studied between 1976 and 2014 in the Nurses’ Health Study, and they compared data from those women with 8,399 others who didn’t have rheumatoid arthritis. When the data was adjusted for factors — such as age, diagnosis year, weight, diet, physical activity, menopausal status, and use of postmenopausal hormones — the RA group was 68 percent likelier to have COPD, but the rates of asthma were about the same (1.11 to 1).

It remains unclear why rheumatoid arthritis patients were likelier to develop chronic obstructive pulmonary disease, and more work needs to be done, according to Sparks. “Possible explanations include shared genetic factors, inflammation, and autoimmunity,” he says.

“Study limitations included the possibility of misclassification of COPD and asthma as well as a lack of data on RA disease activity and treatments,” reported MedPage.

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