Abstract
The aim of this study was to evaluate the risk of asthma in rheumatoid arthritis patients using matched control group for socioeconomic factors and past medical history. Adults >20 years old were collected from the Korean Health Insurance Review and Assessment Service - National Sample Cohort (HIRA-NSC) from 2002 through 2013. A total of 6,695 individuals with rheumatoid arthritis were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 26,780 individuals included in a control group. In both the rheumatoid arthritis and control groups, subjects’ history of asthma was evaluated. Asthma (J45 and J46) and rheumatoid arthritis (M05 and M06) were included based on the International Classification of Disease-10 (ICD-10) codes and medication history. The crude and adjusted (depression and Charlson Comorbidity Index) hazard ratios (HRs) and 95% confidence intervals (CI) of asthma for rheumatoid arthritis patients were analyzed using a stratified Cox proportional hazard model. Subgroup analyses were conducted according to age and sex, number of treatment histories, and medication histories. Approximately 16.4% (1,095/6,695) of rheumatoid arthritis group and 13.0% (3,469/26,780) of the control group had asthma (P < 0.001). The rheumatoid arthritis group demonstrated a higher adjusted HR for asthma than the control group (adjusted HR = 1.23, 95% CI = 1.15–1.32, P < 0.001). This result was consistent in all subgroups. Rheumatoid arthritis was related to an increase risk of asthma.
Highlights
Rheumatoid arthritis is an autoimmune disease that manifests as a synovial inflammation, hyperplasia and joint, cartilage and bone destruction[1]
The adjusted hazard ratios (HRs) of asthma was 1.23 in the rheumatoid arthritis group compared to the control group
According to the types of medications, rheumatoid arthritis patients who treated with methotrexate, lefunomide, and other medications demonstrated 1.27, 1.23, and 1.20 higher adjusted HRs for asthma (Table 5)
Summary
Rheumatoid arthritis is an autoimmune disease that manifests as a synovial inflammation, hyperplasia and joint, cartilage and bone destruction[1]. A few prior longitudinal follow-up studies reported an increased risk of rheumatoid arthritis in asthma patients[20,21]. Only one recent population cohort study described a high risk of asthma in rheumatoid arthritis patients[5]. The running hypothesis of the present study was that rheumatoid arthritis could increase the risk of asthma in an adult population independent of demographic factors and patients’ past medical history. To prove this hypothesis, we used a large, population cohort database of medical claim codes. Participants’ past medical history of hypertension, diabetes, and dyslipidemia were matched between the study and control groups
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