Most reports of pulmonary manifestations in rheumatoid arthritis (RA) have been related to interstitial lung diseases. RA and COPD are both chronic inflammatory systemic diseases. Does RA increase the risk of developing COPD? Is there a difference between seropositive and seronegative RA in the risk of COPD? Using the Korean National Health Insurance Database, we screened individuals diagnosed with RA between 2010 and 2017. We identified 46,030 patients with RA (32,608 with seropositive RA and 13,422 with seronegative RA) and 230,150 matched control individuals; we monitored them until December 2019. We used multivariate Cox proportional hazard models to estimate the adjusted hazard ratio (aHR) of risk factors for the development of COPD. The incidence of COPD among patients with RA was 5.04 per 1,000 person-years; it was 2.23 per 1,000 person-years in the control group. Patients with RA showed a higher risk of developing COPD (aHR, 2.11; 95% CI, 1.96-2.28) compared with the control group. Although both seropositive RA and seronegative RA were associated with an increased risk of COPD, patients with seropositive RA had a higher risk for the development of COPD (aHR, 1.26; 95% CI, 1.09-1.46) than patients with seronegative RA. In the subgroup analyses, smoking history did not demonstrate significant interactions between RA and COPD development. RA was shown to be associated with an increased risk of COPD development, augmented by seropositivity. Physicians should monitor respiratory symptoms and pulmonary function carefully in patients with RA.

中文翻译：

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类风湿性关节炎会增加慢性阻塞性肺病的风险吗？：一项全国回顾性队列研究

大多数类风湿性关节炎（RA）肺部表现的报告都与间质性肺疾病有关。 RA和COPD都是慢性炎症性全身性疾病。 RA 会增加患 COPD 的风险吗？血清反应阳性和血清反应阴性的 RA 患 COPD 的风险有区别吗？使用韩国国民健康保险数据库，我们对 2010 年至 2017 年间诊断为 RA 的个体进行了筛查。我们确定了 46,030 名 RA 患者（32,608 名血清阳性 RA 和 13,422 名血清阴性 RA）和 230,150 名匹配的对照个体；我们对它们进行监测直至 2019 年 12 月。我们使用多变量 Cox 比例风险模型来估计发生 COPD 的风险因素的调整后风险比 (aHR)。 RA 患者中 COPD 的发病率为每 1000 人年 5.04 例；对照组为每 1,000 人年 2.23 例。与对照组相比，RA 患者患 COPD 的风险更高（aHR，2.11；95% CI，1.96-2.28）。尽管血清阳性 RA 和血清阴性 RA 均与 COPD 风险增加相关，但血清阳性 RA 患者发生 COPD 的风险高于血清阴性 RA 患者（aHR，1.26；95% CI，1.09-1.46）。在亚组分析中，吸烟史并未显示出 RA 和 COPD 发展之间存在显着的相互作用。研究表明，RA 与慢性阻塞性肺病 (COPD) 发展风险增加相关，且血清阳性会加剧这种风险。医生应仔细监测 RA 患者的呼吸道症状和肺功能。