Background/Purpose:  While rheumatoid arthritis is associated with a number of different lung conditions, the relationship with osteoarthritis, overwhelmingly the most frequent type of arthritis in the population, has been less well studied. Objective: to examine whether arthritis is associated with an increased likelihood of reporting asthma and/or COPD.

Methods:  Data from the 2011- 2012 Canadian Community Health Survey, a representative survey of the household population, restricting analyses to the population age >= 35 years (n=88,734). Participants were asked about specific long term health conditions diagnosed by a health professional, including arthritis (excluding fibromyalgia), asthma, and COPD (specifically chronic bronchitis, emphysema or chronic obstructive pulmonary disease). Multinominal logistic regression was used to examine associations between lung conditions (none, asthma only, COPD only, both asthma and COPD) and arthritis, controlling for covariates: age, sex, education, household income, smoking status (never, former, current), body mass index (BMI: underweight, normal, overweight, obese), and mean number of other chronic conditions (out of 9). Sensitivity analysis: a) analyses were restricted to those reporting OA; b) analyses were stratified by BMI categories given the strong association of obesity and arthritis and the possibility of metabolic/inflammatory pathways.

Results:  People with arthritis (23 % of the population) more frequently reported lung conditions than those without, respectively asthma only 8.2% vs 5.5%, COPD only 5.4% vs 2.0%, and asthma+COPD 3.4% vs 0.8%. Compared to those without, people with arthritis, were more likely to be current or former smokers (70.3% vs 57.0%), to be obese (26.8% vs 16.7%) and have more other chronic conditions (mean 1.5 vs 0.5). In regression analyses arthritis was significantly associated with all lung conditions: OR (95%CI): asthma only 1.48 (1.26, 1.73); COPD only 1.60 (1.34, 1.91); asthma+COPD 1.98 (1.65, 2.37). The odds of all lung conditions were significantly higher for females. Being a current or former smoker was significantly associated with COPD, but not with asthma. Obesity and the number of other chronic conditions were significant risk factors for reporting all lung conditions. Sensitivity analyses: results were unchanged when restricted to OA. Analyses stratified by BMI categories gave similar results.

Conclusion:  This population-based study confirms a relationship between arthritis and lung diseases, and adds to the scant previous literature. The increased odds of reporting lung diseases by people with arthritis raises questions as to the mechanism. The consistency of the association over BMI categories suggests pathways other than those mediated by metabolic/inflammatory factors. The findings also suggest that recommendations for the management of arthritis should consider the potential implications of having lung disease, for example, for physical activity.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-association-of-arthritis-and-lung-diseases-a-population-based-study/