Extending Service Beyond Active Duty: Generalizability of Rheumatoid Arthritis Research Conducted Among US Veterans

Biomedical research involving US veterans continues to advance health care beyond the Veterans Health Administration. This is particularly true in rheumatoid arthritis (RA), where veteran-centric research has uncovered novel insights into pathogenesis, risk factors, and disease manifestations, informing clinical care and research across both veteran and nonveteran populations. This includes clinical trials and epidemiologic studies in cardiovascular disease, frailty, glucocorticoid use and complications, malignancy, medication adherence, mental health, metabolic comorbidity, mortality, multimorbidity, osteoporosis, RA-associated interstitial lung disease, sex differences in treatment response, and smoking or other environmental interactions. Given the unique characteristics of the veteran population, the generalizability of veteran-centric research findings toward other populations has been questioned. Although there are certain exposures specific to the veteran population (eg, burn pits or toxic exposures), most RA research objectives in veterans, including those listed above, are equally relevant to the nonveteran population, and their generalizability across these groups should be carefully considered. The aim of this review is to compare findings between veteran and nonveteran populations, demonstrating and supporting the generalizability of this research.