한빛사논문
- 조회432
Chiwook Chung MD 1∗, Hyungjin Kim MD, PhD 2,3∗, Kyungdo Han PhD 4, Jinhyoung Jung PhD 5, Yeonghee Eun MD, PhD 6, Hyun Lee MD 7, Junhee Park MD 8, Dong Wook Shin MD, PhD, Dr. PH 8,9,†, Sei Won Lee MD, PhD 10,†
1Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
2Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
3Department of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
4Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
5Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
6Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
7Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
8Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
9Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea
10Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
∗Chiwook Chung and Hyungjin Kim contributed equally to this work as first authors.
†Dong Wook Shin and Sei Won Lee contributed equally to this work as corresponding authors.
Corresponding authors: Dong Wook Shin, MD, DrPH, MBA, Sei Won Lee, MD, PhD
Abstract
Background: Most reports of pulmonary manifestations in rheumatoid arthritis (RA) have been related to interstitial lung diseases. RA and chronic obstructive pulmonary disease (COPD) are both chronic inflammatory systemic diseases.
Research question: Does RA increase the risk of developing COPD? Is there a difference between seropositive and seronegative RA in the risk of COPD?
Study design and methods: 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 seropositive RA and 13,422 seronegative RA) and 276,180 matched control individuals, and 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.
Results: The incidence of COPD among patients with RA was 5.04/1,000 person-year and 2.23/1,000 person-year in the control group. Patients with RA showed a higher risk of developing COPD (aHR 2.11, 95% confidence interval [CI] 1.96-2.28) compared with the control group. While 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) compared with patients with seronegative RA. In the subgroup analyses, smoking history did not demonstrate significant interactions between RA and COPD development.
Interpretation: RA is associated with an increased risk of COPD development, augmented by seropositivity. Clinicians should monitor respiratory symptoms and pulmonary function carefully in patients with RA.
논문정보
- Research article
- 2024년 02월 (BRIC 등록일 2024-02-19)
- 국내 연구진
- 의약학 > 면역의학
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