Association of Asthma with Rheumatoid Arthritis: A Population-Based Case-Control Study (2022)

Table of Contents
The Journal of Allergy and Clinical Immunology: In Practice Background Objective Methods Results Conclusions Section snippets Study setting Study subjects Discussion Acknowledgements References (51) JAllergy Clin Immunol JAllergy Clin Immunol JAllergy Clin Immunol Immunity Lancet Mayo Clin Proc JAllergy Clin Immunol Pract JAllergy Clin Immunol JAllergy Clin Immunol Ann Epidemiol Ann Epidemiol Respir Med Mayo Clin Proc Best Pract Res Clin Rheumatol The pathogenesis of rheumatoid arthritis NEngl J Med Synovial fluid T cell clones from oligoarticular juvenile arthritis patients display a prevalent Th1/Th0-type pattern of cytokine secretion irrespective of immunophenotype Clin Exp Immunol Rheumatoid arthritis: pathophysiology and implications for therapy NEngl J Med Help for the helpers: cooperation between group 2 innate lymphoid cells and T helper 2 cells in allergic asthma Allergy Airway molecular endotypes of asthma: dissecting the heterogeneity Curr Opin Allergy Clin Immunol Risks for infection in patients with asthma (or other atopic conditions): is asthma more than a chronic airway disease? JAllergy Clin Immunol Gene expression in relation to exhaled nitric oxide identifies novel asthma phenotypes with unique biomolecular pathways Am J Respir Crit Care Med Acommunity-based study of the epidemiology of asthma: incidence rates, 1964-1983 Am Rev Respir Dis Incidence and time trends of herpes zoster in rheumatoid arthritis: a population-based cohort study Arthritis Care Res (Hoboken) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis Arthritis Rheum Interobserver variability in medical record review: an epidemiological study of asthma JClin Epidemiol Cited by (21) The prevalence of comorbidity in rheumatoid arthritis: A systematic review and meta-analysis Association of Sinusitis and Upper Respiratory Tract Diseases With Incident Rheumatoid Arthritis: A Case-control Study Allergic conditions and risk of rheumatoid arthritis: A Swedish case-control study Recommended articles (6) Related content Videos
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The Journal of Allergy and Clinical Immunology: In Practice

Volume 6, Issue 1,

January–February 2018

, Pages 219-226

Background

TH1 and TH2 cells have counterregulatory relationships. However, the relationship between asthma, a TH2-predominant condition, and risk of systemic inflammatory diseases such as rheumatoid arthritis (RA), a TH1 condition, is poorly understood.

Objective

We aimed to determine whether asthma was associated with increased risks of incident RA among adults.

Methods

We conducted a retrospective population-based case-control study that examined existing incident RA cases and controls matched by age, sex, and registration year from the general population in Olmsted County, Minnesota, between January 2002 and December 2007. We performed comprehensive medical record reviews to ascertain asthma status using predetermined asthma criteria. The frequency of a history of asthma before the index date was compared between cases and controls. Logistic regression models were used to adjust for confounding factors.

Results

We enrolled 221 RA cases and 218 controls. Of the 221 RA cases, 156 (70.6%) were females, 207 (93.7%) were white, the median age at the index date was 52.5 years, and 53 (24.0%) had a history of asthma. Controls had similar characteristics except that 35 of 218 controls (16.1%) had a history of asthma. After adjustment for sex, age, smoking, body mass index, socioeconomic status, and comorbidity, asthma was significantly associated with increased risks of RA (adjusted odds ratio, 1.74; 95% CI, 1.05-2.90; P= .03).

Conclusions

Despite the counterregulatory relationship between TH1 and TH2 cells, patients with asthma had a significantly higher risk of developing RA than healthy individuals.

Section snippets

Study setting

All subjects were residents of Olmsted County, Minnesota, which is located in southeastern Minnesota.9 The Olmsted County population is similar to the US white population, with the exception of a higher proportion of the working population employed in the health care industry.10 Medical records–based research using the geographically defined population of Olmsted County is possible through the Rochester Epidemiology Project (REP).9 The REP record-linkage system links all inpatient and

(Video) Asthma and Proinflammatory Conditions: A Population-Based Retrospective Matched Cohort Study

Study subjects

A total of 221 cases and 218 controls were included after excluding 35 subjects causing imbalance between groups. The reasons for exclusion were no research authorization (n= 23, change from the original study), insufficient medical records to determine asthma (n= 1), bullous emphysema or pulmonary fibrosis on chest x-ray (n= 4), kyphoscoliosis or bronchiectasis (n= 6), and hyper-IgA syndrome (n= 1).

The sociodemographic characteristics of the subjects are summarized in TableII. Overall,

Discussion

This population-based study in adults suggests that asthma is associated with an increased risk of RA. This may also be true for other atopic conditions, such as AR. Asthma medications or other comorbid conditions such as chronic obstructive pulmonary disease did not account for this association because they were not associated with the risk of RA.

Our study results are consistent with a previous study showing the female predominance of RA epidemiology (71%).1 We found a previously reported

Acknowledgements

We thank Ms Kelly Okeson for her administrative assistance and the original project staff.

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    • Timing of sinusitis and other respiratory tract diseases and risk of rheumatoid arthritis

      2022, Seminars in Arthritis and Rheumatism

      To investigate the association between timing of respiratory tract diseases and risk of rheumatoid arthritis (RA).

      This case-control study using the Mass General Brigham Biobank matched incident RA cases, confirmed by ACR/EULAR criteria, with at least seven years preceding electronic health record (EHR) data to three controls on age, sex, and EHR history from RA diagnosis (index date). We ascertained timing (>0-5 years/>5–10 years/>10 years) of the first documented respiratory tract disease prior to index date using diagnosis codes. We estimated odds ratios (OR) with 95% confidence intervals (CI) for RA for each respiratory exposure using logistic regression models, adjusting for potential confounders. We also conducted a stratified analysis by serostatus and smoking.

      We identified 625 incident RA cases (median 56 years, 75% female, 57% seropositive) and 1,875 controls. Acute sinusitis was associated with RA only in the >5 to 10 years before RA (OR 3.90, 95% CI:1.90,8.01). In contrast, pneumonia was associated with RA only in the >0 to 5 years before RA (OR 1.73, 95% CI:1.00,3.00), and chronic respiratory tract diseases only >10 years before RA (OR 1.43, 95% CI:1.00,2.05). All respiratory tract diseases tended to show a stronger association with seronegative RA than seropositive RA, although the interaction was statistically significant only for chronic sinusitis (p=0.04). Respiratory diseases showed a nonsignificantly stronger association among smokers than nonsmokers.

      Sinusitis and other respiratory diseases are associated with increased risk of RA, especially 5 years before RA onset. RA may begin many years before clinical onset.

    • Patients with asthma have a higher risk of rheumatoid arthritis: A systematic review and meta-analysis

      2020, Seminars in Arthritis and Rheumatism

      This study aimed to investigate whether patients with asthma have a higher risk of incident rheumatoid arthritis (RA) using systematic review and meta-analysis technique.

      Potentially eligible studies were identified from Medline and EMBASE databases from inception to May 2020 using search strategy that comprised of terms for “Asthma” and “Rheumatoid arthritis”. Eligible cohort study must consist of one cohort of patients with asthma and another cohort of individuals without asthma. Then, the study must effect estimates with 95% confidence intervals (95% CIs) comparing incident RA between the groups. Eligible case-control studies must include cases with RA and controls without RA. Then, the study must explore their history of asthma. Odds ratio (OR) with 95% CIs of the association between asthma status and RA must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method.

      A total of 22,442 articles were identified. After two rounds of independent review by three investigators, six cohort studies and fourteen case-control studies met the eligibility criteria and were included into the meta-analysis. Meta-analysis of cohort studies found that patients with asthma had a significantly higher risk of RA compared with individuals without asthma with the pooled hazard ratio of 1.42 (95% CI, 1.18 – 1.70). Meta-analysis of case-control studies revealed that patients with asthma had a higher risk of RA compared with individuals without asthma with the pooled odds ratio of 1.33 (95%CI, 0.97 – 1.83). Funnel plot for the meta-analysis of case-control studies was asymmetric, suggesting the presence of publication bias.

      This systematic review and meta-analysis found a significant association between asthma and higher risk of incident RA.

    • A case of severe eosinophilic asthma and refractory rheumatoid arthritis well controlled by combination of IL-5Rα antibody and TNFα inhibitor

      2019, Allergology International

    • The prevalence of comorbidity in rheumatoid arthritis: A systematic review and meta-analysis

      2022, British Journal of Community Nursing

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    Journal of Allergy and Clinical Immunology: In Practice , 6 (1), 219-226. https://doi.org/10.1016/j.jaip.2017.06.022. Sheen, YH, Rolfes, MC , Wi, CI, Crowson, CS , Pendegraft, RS, King, KS , Ryu, E & Juhn, YJ 2018, ' Association of Asthma with Rheumatoid Arthritis: A Population-Based Case-Control Study ', Journal of Allergy and Clinical Immunology: In Practice , vol.. Of the 221 RA cases, 156 (70.6%) were females, 207 (93.7%) were white, the median age at the index date was 52.5 years, and 53 (24.0%) had a history of asthma.. After adjustment for sex, age, smoking, body mass index, socioeconomic status, and comorbidity, asthma was significantly associated with increased risks of RA (adjusted odds ratio, 1.74; 95% CI, 1.05-2.90; P =.03).. Conclusions Despite the counterregulatory relationship between TH1 and TH2 cells, patients with asthma had a significantly higher risk of developing RA than healthy individuals.. Of the 221 RA cases, 156 (70.6%) were females, 207 (93.7%) were white, the median age at the index date was 52.5 years, and 53 (24.0%) had a history of asthma.. After adjustment for sex, age, smoking, body mass index, socioeconomic status, and comorbidity, asthma was significantly associated with increased risks of RA (adjusted odds ratio, 1.74; 95% CI, 1.05-2.90; P =.03).. Conclusions Despite the counterregulatory relationship between TH1 and TH2 cells, patients with asthma had a significantly higher risk of developing RA than healthy individuals.. Of the 221 RA cases, 156 (70.6%) were females, 207 (93.7%) were white, the median age at the index date was 52.5 years, and 53 (24.0%) had a history of asthma.. After adjustment for sex, age, smoking, body mass index, socioeconomic status, and comorbidity, asthma was significantly associated with increased risks of RA (adjusted odds ratio, 1.74; 95% CI, 1.05-2.90; P =.03).. Conclusions Despite the counterregulatory relationship between TH1 and TH2 cells, patients with asthma had a significantly higher risk of developing RA than healthy individuals.

    However, the relationship between asthma, a T H 2-predominant condition, and risk of systemic inflammatory diseases such as rheumatoid arthritis (RA), a T H 1 condition, is poorly understood.. Controls had similar characteristics except that 35 of 218 controls (16.1%) had a history of asthma.. Asthma medications or other comorbid conditions such as chronic obstructive pulmonary disease did not account for this association because they were not associated with the risk of RA.. Personal and family medical history correlates of rheumatoid arthritis. To investigate the association between timing of respiratory tract diseases and risk of rheumatoid arthritis (RA).. Eligible case-control studies must include cases with RA and controls without RA.. This systematic review and meta-analysis found a significant association between asthma and higher risk of incident RA.. The Reflux Symptom Index (RSI) is a clinical tool to predict the presence of LPR, but a threshold RSI score has never been validated for the diagnosis of LPR in an allergic patient population.

    Conditional logistic regression analysis suggested that when compared with controls, the OR for prior RA among cases was 1.66 (95% CI = 1.47-1.87, P <0.001) after adjusting for diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraine, sicca syndrome, allergy, endometriosis, asthma, overactive bladder, tobacco use disorder, and alcohol abuse.. Additionally, BPS/IC was consistently and significantly associated with a previous diagnosis of RA regardless of prescription drug use; the OR for prior RA among groups prescribed ≤1 type of disease-modifying antirheumatic drug (DMARD), two types of DMARDs, and ≥3 types of DMARDs or TNF-alpha inhibitor when compared to controls were 1.49 (95% CI = 1.28-1.72), 1.91 (95% CI = 1.38-2.68), and 2.36 (95% CI = 1.77-3.17), respectively.. Interstitial Cystitis Medicine & Life Sciences 100% Rheumatoid Arthritis Medicine & Life Sciences 60% Case-Control Studies Medicine & Life Sciences 59% Antirheumatic Agents Medicine & Life Sciences 32% Odds Ratio Medicine & Life Sciences 17% Logistic Models Medicine & Life Sciences 11% Chronic Fatigue Syndrome Medicine & Life Sciences 11% Overactive Urinary Bladder Medicine & Life Sciences 11%. Conditional logistic regression analysis suggested that when compared with controls, the OR for prior RA among cases was 1.66 (95% CI = 1.47-1.87, P <0.001) after adjusting for diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraine, sicca syndrome, allergy, endometriosis, asthma, overactive bladder, tobacco use disorder, and alcohol abuse.. Additionally, BPS/IC was consistently and significantly associated with a previous diagnosis of RA regardless of prescription drug use; the OR for prior RA among groups prescribed ≤1 type of disease-modifying antirheumatic drug (DMARD), two types of DMARDs, and ≥3 types of DMARDs or TNF-alpha inhibitor when compared to controls were 1.49 (95% CI = 1.28-1.72), 1.91 (95% CI = 1.38-2.68), and 2.36 (95% CI = 1.77-3.17), respectively.. Conditional logistic regression analysis suggested that when compared with controls, the OR for prior RA among cases was 1.66 (95% CI = 1.47-1.87, P <0.001) after adjusting for diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraine, sicca syndrome, allergy, endometriosis, asthma, overactive bladder, tobacco use disorder, and alcohol abuse.. Additionally, BPS/IC was consistently and significantly associated with a previous diagnosis of RA regardless of prescription drug use; the OR for prior RA among groups prescribed ≤1 type of disease-modifying antirheumatic drug (DMARD), two types of DMARDs, and ≥3 types of DMARDs or TNF-alpha inhibitor when compared to controls were 1.49 (95% CI = 1.28-1.72), 1.91 (95% CI = 1.38-2.68), and 2.36 (95% CI = 1.77-3.17), respectively.. Conditional logistic regression analysis suggested that when compared with controls, the OR for prior RA among cases was 1.66 (95% CI = 1.47-1.87, P <0.001) after adjusting for diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraine, sicca syndrome, allergy, endometriosis, asthma, overactive bladder, tobacco use disorder, and alcohol abuse.. Additionally, BPS/IC was consistently and significantly associated with a previous diagnosis of RA regardless of prescription drug use; the OR for prior RA among groups prescribed ≤1 type of disease-modifying antirheumatic drug (DMARD), two types of DMARDs, and ≥3 types of DMARDs or TNF-alpha inhibitor when compared to controls were 1.49 (95% CI = 1.28-1.72), 1.91 (95% CI = 1.38-2.68), and 2.36 (95% CI = 1.77-3.17), respectively.

    Therefore, in this study, we. attempted to determine the relationship between RA and respiratory. allergic diseases and the underlying relationship of Th1 and Th2. diseases through a cross-sectional population-based study done in South. Korea.. As for prevalence of respiratory allergic. diseases, there was a difference between the control and case group,. with 29 participants having prevalence in both RA and respiratory. allergic diseases.. Discussion. Through our cross-sectional study using KNHANES data from 2013 to. 2015, it was clearly found that participants with prevalence of. respiratory allergic diseases (asthma and allergic rhinitis) had a. significantly increased risk of prevalence of RA.. According to a nationwide population-based cohort study done in Taiwan. [9], they found parallel results, where patients with allergic diseases,. in particular, asthma and allergic rhinitis, had a significantly. increased risk of developing RA.. To the best of our knowledge, this study is the first to show that. people with respiratory allergic diseases have an increased risk of. prevalence of RA in South Korea, with the two major types of respiratory. allergic diseases (asthma and allergic rhinitis) and its. inner-relationship among these two taken into consideration.. In addition, to appreciate. the underlying temporal relationship that may exist, only RA cases that. were diagnosed at an age older than the respiratory allergic diseases. diagnosis age were included in the study.. Despite all the mentioned above, our study's findings. support the hypothesis that Th1 and Th2 diseases could coexist and that. prevalence of respiratory allergic diseases increases the risk of RA.. (i) Prevalence of respiratory allergic diseases,. especially asthma, has an increased risk of RA prevalence.. Tu, and Y.-F. Li,. "The risk of asthma in rheumatoid arthritis: a population based. cohort study," QJM: An International Journal of Medicine, vol.. Evaluation of asthma incidence in children. with coeliac disease, type 1 diabetes, or rheumatoid arthritis: A. register study," The Journal of Allergy and Clinical Immunology,. vol.. [29] Y. H. Sheen, M. C. Rolfes, C. Wi et al., "Association of. Asthma with Rheumatoid Arthritis: A Population-Based Case-Control. Study," The Journal of Allergy and Clinical Immunology, vol.

    Patients with RA may be advised to avoid additional precipitating factors of PG.Key Points• The odds of developing PG are increased by more than threefold in patients with RA.• PG followed the diagnosis of RA in the majority of patients with these coexistent conditions by an average latency of 9.2 years.• Patients with RA-associated were older relative to other patients with PG at the onset of PG.. Patients with RA may be advised to avoid additional precipitating factors of PG.Key Points• The odds of developing PG are increased by more than threefold in patients with RA.• PG followed the diagnosis of RA in the majority of patients with these coexistent conditions by an average latency of 9.2 years.• Patients with RA-associated were older relative to other patients with PG at the onset of PG.. note = "Publisher Copyright: {\textcopyright} 2020, International League of Associations for Rheumatology (ILAR).. Patients with RA may be advised to avoid additional precipitating factors of PG.Key Points• The odds of developing PG are increased by more than threefold in patients with RA.• PG followed the diagnosis of RA in the majority of patients with these coexistent conditions by an average latency of 9.2 years.• Patients with RA-associated were older relative to other patients with PG at the onset of PG.. Patients with RA may be advised to avoid additional precipitating factors of PG.Key Points• The odds of developing PG are increased by more than threefold in patients with RA.• PG followed the diagnosis of RA in the majority of patients with these coexistent conditions by an average latency of 9.2 years.• Patients with RA-associated were older relative to other patients with PG at the onset of PG.

    Some of the prior literature investigated the potential association between rheumatoid arthritis (RA) and Alzheimer's disease (AD) because these two diseases may share similar inflammatory mechanisms.. The study found that 330 (3.63%) of the total sampled patients had an RA diagnosis before the index date.. Additionally, prior RA was found in 60 (2.64%) cases and in 270 (3.96%) controls.. After adjusting for patients' geographic location, urbanization level, and comorbidities, the adjusted OR of prior RA for patients with AD was 0.73 (95% CI: 0.55~0.98) compared to those without AD.. case-control studies Agriculture & Biology 100% rheumatoid arthritis Agriculture & Biology 92% Alzheimer disease Agriculture & Biology 90% Cholinesterase Inhibitor Chemical Compounds 89% Rheumatoid Arthritis Medicine & Life Sciences 60% Case-Control Studies Medicine & Life Sciences 59% Alzheimer Disease Medicine & Life Sciences 56% odds ratio Agriculture & Biology 34%. Kao, LT , Kang, J-H, Lin, H-C, Huang, C-C, Lee, H-C & Chung, SD 2016, ' Rheumatoid arthritis was negatively associated with Alzheimer's disease: A population-based case-control study ', PLoS One , vol.. abstract = "Some of the prior literature investigated the potential association between rheumatoid arthritis (RA) and Alzheimer's disease (AD) because these two diseases may share similar inflammatory mechanisms.. The study found that 330 (3.63%) of the total sampled patients had an RA diagnosis before the index date.. Additionally, prior RA was found in 60 (2.64%) cases and in 270 (3.96%) controls.. N2 - Some of the prior literature investigated the potential association between rheumatoid arthritis (RA) and Alzheimer's disease (AD) because these two diseases may share similar inflammatory mechanisms.. The study found that 330 (3.63%) of the total sampled patients had an RA diagnosis before the index date.. Additionally, prior RA was found in 60 (2.64%) cases and in 270 (3.96%) controls.. AB - Some of the prior literature investigated the potential association between rheumatoid arthritis (RA) and Alzheimer's disease (AD) because these two diseases may share similar inflammatory mechanisms.. The study found that 330 (3.63%) of the total sampled patients had an RA diagnosis before the index date.. Additionally, prior RA was found in 60 (2.64%) cases and in 270 (3.96%) controls.

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