Patients with rheumatoid arthritis (RA) who have comorbid chronic obstructive pulmonary disease (COPD) have a significantly increased risk for mortality, according to results published in Respiratory Medicine.

The results of the study emphasize the need for rheumatologists, pulmonologists, and primary care clinicians to collaborate to improve outcomes for patients with RA and COPD.

The study included participants with a first-time diagnosis of RA in the Danish National Patient Registry between 2004 and 2014. Participants with RA and COPD were matched with participants with RA without COPD for year of birth, sex, and age at RA diagnosis. The researchers used Kaplan-Meier mortality curves to assess mortality risk and estimated adjusted hazard rate ratios (aHRRs) for death, using Cox regression models.


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Overall, the researchers identified 31,333 participants with RA, 10.4% (n=3254) of whom also had a diagnosis of COPD and were matched to 9706 participants without COPD.

The mortality risk for participants with RA and COPD was 4.5% within 2 to 6 months compared with 1.5% for participants without COPD (aHRR, 3.0; 95% CI, 2.3-3.9). Within 0.5 to 10 years, the mortality risks were 59.3% and 39.8%, respectively (aHRR, 2.1; 95% CI, 1.9-2.1).

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“COPD is a major cause of morbidity; it is associated with increased risk of other serious comorbidities and causes severe excess mortality. The need for optimal pharmacological and non-pharmacological treatment for COPD, including smoking cessation and rehabilitation, is obvious based on these findings,” the researchers wrote.

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Reference

Hyldgaard C, Bendstrup E, Pedersen AB, et al. Increased mortality among patients with rheumatoid arthritis and COPD: a population-based study. Respir Med. 2018;140:101-107.