Mortality risk in patients with arthritis rises with comorbid COPD
Key takeaways:
- Patients with arthritis and COPD vs. without COPD had a significantly heightened adjusted risk for all-cause mortality.
- This was also the case for CVD and chronic lower respiratory disease mortality.
The risk for all-cause and cardiovascular disease mortality was heightened when adults had arthritis plus comorbid COPD, according to data published in Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation.
“For clinicians, these findings underscore the importance of screening arthritis patients for COPD, especially given the heightened risk of mortality,” Chengfeng Fu, MM, pulmonologist at the Second People’s Hospital of Banan District in Chongqing, China, told Healio. “Identifying COPD early can lead to more aggressive management strategies, potentially improving outcomes and reducing the risk of adverse events.”
Using 1999 to 2018 data from the National Health and Nutrition Examination Survey, Fu and colleagues assessed 1,795 patients with self-reported arthritis plus COPD (mean age, 59.8 years; 66.63% women; 81.32% non-Hispanic white) and 9,503 patients with self-reported arthritis without COPD (mean age, 59 years; 58.79% women; 77.61% non-Hispanic white) to determine how the risk for mortality differs between the two sets of patients.
Researchers noted that 3,061 deaths occurred in the 8.8-year average follow-up period. When evaluating for CVD-related mortality, 1,024 deaths emerged.
Between the arthritis plus COPD group and the arthritis without COPD group, the risk for all-cause mortality was significantly elevated among those with COPD (adjusted HR = 1.41; 95% CI, 1.25-1.6) in a model adjusted for several variables: age, sex, race/ethnicity, marital status, poverty-to-income ratio, education level, BMI, physical activity, smoking status, drinking status, hypertension and diabetes.
Similarly, patients with arthritis and comorbid COPD vs. without COPD had a significantly heightened adjusted risk for CVD mortality (aHR = 1.29; 95% CI, 1.08-1.53; P < .001), according to the study.
Following in line with the above findings, researchers reported that those with both arthritis and COPD had significantly greater crude mortality rates on Kaplan-Meier survival curves vs. those with arthritis without COPD.
“One of the most striking findings from our study was the significant increase in both all-cause and CVD mortality among arthritis patients with COPD,” Fu told Healio. “Although this conclusion may have come as a surprise, it appears reasonable when considering clinical practice and the underlying pathogenesis.”
The study also broke down deaths by chronic lower respiratory disease. The risk for chronic lower respiratory disease mortality was significantly raised in the group with arthritis plus vs. without COPD (aHR = 5.46; 95% CI, 3.48-8.56), and this was also the case when analyzing the risk for non-chronic lower respiratory disease mortality, with a greater risk observed among those with both arthritis and COPD (aHR = 1.24; 95% CI, 1.07-1.44).
“[There is a] need for further research in this area to better understand the complex interactions between these conditions and to develop more effective treatment approaches,” Fu told Healio.
“Future research will focus on understanding the mechanisms underlying the increased mortality risk in this population,” Fu said. “We plan to explore the role of inflammation, shared risk factors and the potential for targeted interventions that can mitigate the effects of COPD in arthritis patients.”
For more information:
Chengfeng Fu, MM, can be reached at chengfengfu@stu.cqmu.edu.cn.
Reference:
- People with COPD and arthritis have an increased risk of death. https://www.copdfoundation.org/About-Us/Press-Room/Press-Releases/Article/2164/People-with-COPD-and-arthritis-have-an-increased-risk-of-death.aspx. Published March 11, 2025. Accessed March 11, 2025.
Perspective
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While the findings are expected, this is a nationally representative sample and highlights how COPD and arthritis can place people at risk for poor outcomes, even from non-COPD causes. Our previous research found that patients with rheumatoid arthritis (RA) and emphysema have high mortality, so this fits my experience.
This study may lead to more awareness for patients and clinicians about how people with arthritis and COPD could be a vulnerable population. Thinking about the next step, this research lumped all types of arthritis into a single category. Rheumatologists would want to investigate specific types of arthritis, such as RA, and understand optimal treatment for both conditions.
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