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
{"title":"Rheumatoid arthritis and changes on spirometry by smoking status in two prospective longitudinal cohorts.","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","doi":"10.1136/rmdopen-2024-004281","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare longitudinal changes in spirometric measures between patients with rheumatoid arthritis (RA) and non-RA comparators.</p><p><strong>Methods: </strong>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<sub>1</sub>%) 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<sub>1</sub>/FVC <0.7).</p><p><strong>Results: </strong>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<sub>1</sub>% decline (β=-0.49, p=0.04). However, in ever smokers with ≥10 pack-years, those with RA exhibited significantly less FEV<sub>1</sub>% 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<sub>1</sub>/FVC decline. No difference was observed in the annual FVC% change in RA versus non-RA.</p><p><strong>Conclusions: </strong>Smokers with RA, especially those with baseline obstructive spirometric patterns, experienced lower FEV<sub>1</sub>% and FEV<sub>1</sub>/FVC decline than non-RA comparators. Conversely, never smokers with RA had more FEV<sub>1</sub>% decline than non-RA comparators. Future studies should investigate potential treatments and the pathogenesis of obstructive lung diseases in smokers with RA.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":null,"pages":null},"PeriodicalIF":5.1000,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184187/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"RMD Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/rmdopen-2024-004281","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
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 (FEV1%) 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 (FEV1/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 FEV1% decline (β=-0.49, p=0.04). However, in ever smokers with ≥10 pack-years, those with RA exhibited significantly less FEV1% 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 FEV1/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 FEV1% and FEV1/FVC decline than non-RA comparators. Conversely, never smokers with RA had more FEV1% decline than non-RA comparators. Future studies should investigate potential treatments and the pathogenesis of obstructive lung diseases in smokers with RA.
期刊介绍:
RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.