Sinusitis, ‘common cold’ may increase risk for developing rheumatoid arthritis
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Sinusitis, acute respiratory tract burden and even pharyngitis — also known as the common cold — are potential risk factors for rheumatoid arthritis, according to data published in The Journal of Rheumatology.
“More and more data are suggesting that rheumatoid arthritis starts outside the joints, in places like the lungs or gut, before it goes to the joints,” Vanessa L. Kronzer, MD, MSCI, of the Mayo Clinic, in Rochester, Minnesota, told Healio Rheumatology. “It appears the upper airway may be another place that it might start.”
To examine whether specific respiratory tract diseases are associated with an increased risk for RA, Kronzer and colleagues conducted a case-control study within the Mass General Brigham Biobank, a research repository from Massachusetts General Hospital, Brigham and Women’s Hospital, and their affiliated centers in the greater Boston area. The researchers identified 741 patients newly diagnosed with RA and matched them to 2,223 non-RA control individuals based on age, sex and electronic health record history.
Respiratory tract disease exposure was defined as one inpatient code, or two outpatient codes, at least 2 years prior to index — the date of RA diagnosis or matched date. The researchers used logistic regression models to determine odds ratios for RA, adjusting for confounders. They then stratified the results by serostatus — with seropositive status defined as the presence of rheumatoid factor and/or anti-citrullinated protein antibodies — and smoking.
According to the researchers, acute sinusitis (OR = 1.61; 95% CI,1.05-2.45), chronic sinusitis (OR = 2.16; 95% CI, 1.39-3.35) and asthma (OR = 1.39; 95% CI, 1.03-1.87) were associated with increased risk for RA. Acute respiratory tract disease burden during the pre-index exposure period was additionally associated with increased RA risk, with an odds ratio of 1.3 per 10 codes (95% CI, 1.08-1.55).
Additionally, acute pharyngitis was associated with seronegative (OR = 1.68; 95% CI, 1.02-2.74), but not seropositive, RA. However, chronic rhinitis/pharyngitis was associated with seropositive (OR = 2.46; 95% CI, 1.01-5.99), but not seronegative, RA.
Respiratory tract diseases generally led to higher associations among smokers, especially those with smoking history of more than 10 pack-years (OR = 1.52; 95% CI, 1.02-2.27).
“[This study] showed that upper airway diseases like sinusitis or even pharyngitis — the common cold — were associated with developing rheumatoid arthritis,” Kronzer said. “The clinical significance of this, first, is that it helps us understand where RA comes from. Second, this might help us prevent RA in people at risk. Perhaps reducing the spread of respiratory infections, ie, vaccines or handwashing, or treating sinusitis might reduce the chance of developing RA, for example.”
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