Rheumatoid Arthritis and Pulmonary Abnormalities on Spirometry

Pavankumar Kamat


May 28, 2021


  • Rheumatoid arthritis (RA) was associated with an increased risk of restrictive and obstructive pattern pulmonary abnormalities on spirometry.

  • The associations were not explained by smoking and existing chronic respiratory illness.

Why this matters

  • Emerging evidence suggests that airways diseases may be common in patients with RA, independent of smoking.

Study design

  • A cross-sectional study of 350,776 participants (2008 with RA and 348,768 control participants) from the UK Biobank who underwent spirometry.

  • Co-primary outcomes: spirometric abnormalities (restrictive or obstructive pulmonary pattern).

  • Secondary outcomes: continuous % predicted forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 25-75% (FEF25-75%) and severity of patterns.

  • Funding: None.

Key results

  • After adjusting for confounders, including smoking, RA vs control group had an increased risk of (adjusted OR [aOR]; 95% CI):

    • restrictive pattern (1.36; 1.21-1.53); and

    • obstructive pattern (1.31; 1.16-1.47).

  • These associations remained significant after further adjustment for known chronic respiratory illness (aOR; 95% CI):

    • restrictive pattern (1.36; 1.21-1.52); and

    • obstructive pattern (1.21; 1.07-1.37).

  • RA vs control group had a significantly lower (β; 95% CI):

    • % predicted FEV1 (−2.93; −3.63 to −2.24) and FVC (−2.08; −2.72 to −1.45);

    • FEV1/FVC (−0.008; −0.010 to −0.005); and

    • FEF25-75% (−4.79; −6.08 to −3.49).

  • In terms of severity of patterns, RA vs control group had the strongest risk of (aOR; 95% CI):

    • severe restrictive pattern (1.86; 1.08-3.23); and

    • severe obstructive pattern (1.54; 1.10-2.16).


  • RA cases were identified using self-reported data and current treatment with RA-specific medications.


Prisco L, Moll M, Wang J, Hobbs BD, Huang W, Martin LW, Kronzer VL, Huang S, Silverman EK, Doyle TJ, Cho MH, Sparks JA. Relationship between rheumatoid arthritis and pulmonary function measures on spirometry in the UK Biobank. Arthritis Rheumatol. 2021 May 13 [Epub ahead of print]. doi: 10.1002/art.41791. PMID: 33982900.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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