Prevalence and risk of chronic obstructive pulmonary disease in rheumatoid arthritis: Systematic review and...

Rheumatoid arthritis (RA) is a chronic autoimmune disease known for its systemic inflammatory effects and associated comorbidities. Chronic obstructive pulmonary disease (COPD) has been increasingly recognized as a significant comorbidity in RA patients. This meta-analysis aims to quantify the prevalence and relative risk of COPD in patients with RA compared to the general population.

A systematic search of PubMed, Embase, and Google Scholar was conducted until April 30th, 2024. Studies were selected based on predefined inclusion criteria, focusing on those reporting data on COPD in RA patients. Random-effects models were used to estimate pooled prevalence rate and risk ratios, along with 95% confidence intervals (CIs), to report the overall effect size. Statistical significance was set at P < .05. Statistical analyses were conducted using Review Manager and MedCalc software, with results pooled using the Mantel-Haenszel random-effects model. Heterogeneity was assessed using I2 statistics, and publication bias was evaluated using funnel plots, Egger regression, and Begg rank correlation tests.

Twenty-four studies with a combined population of 1,710,600 individuals were included. The pooled prevalence of COPD in RA patients was 7.06% (95% CI 4.56-10.13). Subgroup analysis showed a prevalence of 6.36% in Asia and 7.1% in the studies from the rest of the world. RA patients had a significantly higher risk of developing COPD compared to the general population, with an risk ratios of 1.58 (95% CI 1.37-1.82, P < .0001). The relative risk in Asian populations was 1.61 (95% CI, 1.19-2.18, P < .0001) compared to 1.56 (95% CI, 1.24-1.97, P < .0001) in studies from the rest of the world. According to Newcastle-Ottawa Scale, most studies were of high or moderate quality. According to Egger regression and Begg rank correlation tests, all analyses were free of publication bias.

This meta-analysis offers strong evidence that individuals with RA are at a significantly higher risk of developing COPD. These findings emphasize the need for regular screening for COPD in RA patients and the implementation of proactive management strategies to reduce this risk. Further research is required to fully understand this relationship.