Smoking + RA With Obstructive Pattern Shows Less Spirometry Decline

Whereas patients with RA who never smoked had more decline in percent-predicted forced expiratory volume in one second

By Lori Solomon HealthDay Reporter

TUESDAY, June 25, 2024 (HealthDay News) — Patients who have smoked with rheumatoid arthritis (RA) and an obstructive pattern may be a unique phenotype, according to a study published online June 17 in RMD Open.

Keigo Hayashi, M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues compared longitudinal changes in spirometric measures over five to seven years between 233 patients with RA and 37,735 non-RA comparators.

The researchers found that among never-smoking participants without an obstructive pattern, RA was significantly associated with more decline in annual changes in the percent-predicted forced expiratory volume in one second (FEV₁ percent; β =−0.49). In ever smokers with ≥10 pack-years, those with RA exhibited significantly less FEV₁ percent decline than non-RA comparators (β = 0.50). A more pronounced difference was seen among those with an obstructive pattern at baseline (β = 1.12). Similar results were seen for FEV₁/ forced vital capacity (FVC) decline. There was no difference in the annual FVC percent change in RA versus non-RA.

“Further studies are required to explore the mechanisms and potential reversibility of systemic inflammation, autoimmunity and the impact of RA treatments on pulmonary function,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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