Background/Purpose: Only few studies have addressed the prognostic impact of chronic obstructive pulmonary disease (COPD) among patients with rheumatoid arthritis (RA), although both diseases are frequent, and smoking is a shared risk factor. The purpose is to estimate the burden of COPD among RA patients and the subsequent mortality.

Methods: We included patients who had been assigned a first-time diagnosis of RA in the Danish National Patient Registry between 2004 and 2016. RA patients with COPD were matched for birth year, gender, and age at RA diagnosis with RA patients without COPD. Vital status for all patients was obtained from the Civil Registration System. Mortality risks were assessed using Kaplan-Meier mortality curves. Adjusted hazard rate ratios (aHRRs) for death with 95% confidence intervals (CIs) were estimated using Cox regression models. Adjustment was made for seropositive RA and Charlson Comorbidity Index (CCI).

Results: The study population included 31,333 individuals with RA. 3,254 of those (10.4%) had a diagnosis of COPD and were matched to 9,706 RA patients without COPD. The mortality risks in RA patients with COPD and RA patients without COPD within 0-2 months were 3.2% and 0.5% (aHRR = 7.3, CI 4.9-11.0), 4.5% and 1.5% within 2-6 months (aHRR = 3.0, CI 2.3-3.9), and 59.3% and 39.8% within 0.5-10 years (aHRR = 2.1, CI 1.9-2.1).

Conclusion: The mortality risk in RA patients with COPD was significantly increased compared with matched RA patients without COPD. The relative mortality risk was most pronounced within the first two months after both diagnoses had been assigned.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-population-based-cohort-study-of-chronic-obstructive-pulmonary-disease-among-patients-with-rheumatoid-arthritis-comorbidity-and-mortality/