People living with arthritis are at greater risk of a deadly lung disease, it has been warned.
The 400,000 people with rheumatoid arthritis in Britain, and 50 million in the US, are almost 50 per cent more likely to end up with chronic obstructive pulmonary disease (COPD), according to the results of a new study.
Rheumatoid arthritis is a long-term illness in which the immune system causes the body to attack itself, causing painful, swollen and stiff joints.
But the extra problems come from the inflammation it causes in those joints.
The authors of the study, published in the journal Arthritis Care & Research, say people with arthritis should be vigilant in looking for the first signs of COPD, which is the second most common lung disease after asthma in Britain.
The researchers followed 24,625 patients with rheumatoid arthritis and 25,396 people who were free of the condition to record how many were hospitalised with COPD.
While it was once thought COPD was caused by inflammation in the lungs specifically, experts now think inflammation elsewhere in the body could also be a trigger.
Dr Lacaille added: ‘Our results emphasize the need to control inflammation, and in fact to aim for complete eradication of inflammation through effective treatment of rheumatoid arthritis.’
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Rheumatoid arthritis is a well-known disease for causing damage to joints, however the disease can also affect your lungs. It can cause damage to the tissue around the joints as well as your eyes, heart and lungs.
“We call it rheumatoid arthritis, but we should really call it rheumatoid disease,” says Elinor Mody, MD, director of the Brigham and Women’s Hospital Women’s Orthopaedic and Joint Disease Centre in Boston. Besides the joints, the “heart and lungs are the most commonly affected,” Mody says. Doctors aren’t sure how or why rheumatoid arthritis causes other organs to suffer, but lung complications of rheumatoid arthritis can be serious and even cause death.
Interstitial Lung Disease
Rheumatoid arthritis-associated interstitial lung disease, or RA-ILD, is the most serious lung complication for people with rheumatoid arthritis. This illness can be hard to detect, but occurs when lung tissue becomes inflamed and eventually scarred.
* Smoking increases the risk of developing it but non-smokers do develop RA-ILD.
* It causes breathlessness and a dry cough, but in many cases it is symptomless making it difficult to be able to detect it early enough to try and treat it.
* There are trials going on at the moment trialling new drugs to try and treat it but nothing has been very successful so far making the disease difficult to treat, other than treating the symptoms.
The inflammation and scarring caused by RA-ILD can lead to pulmonary fibrosis and permanent scarring of the lung tissues. The air sacs are gradually replaced by scar tissue reducing the respiratory capability of the lungs and resulting in shortness of breath.
* Supplemental oxygen can be used to help make breathing easier but it cannot reverse the dame done by pulmonary fibrosis.
* Methotrexate is a drug commonly used to treat rheumatoid arthritis, however this drug also causes pulmonary fibrosis. If you are on this drug then your
respiratory status needs to be carefully monitored.
Rheumatoid arthritis can also cause nodules to form in the throat and on the vocal cords, causing complications like hoarseness and other changes. Nodules can develop in the lungs as well, but usually don’t cause symptoms and patients may never notice them.
Prevention of Respiratory Issues
Because of the high risk of complications due to rheumatoid arthritis-associated lung disease and the fact that there is little treatment available, prevention is key. To help reduce your risk:
* Don’t smoke. If you do, ask your doctor for suggestions about how to quit smoking immediately. Chemicals found in cigarettes can irritate already delicate lung tissue, leading to further complications.
* Have regular check-ups. Your doctor should listen to your lungs and monitor your breathing at each visit as lung problems that are detected early can be easier to treat. Talk to your doctor about any shortness of breath you’re experiencing and ask about changing medications or starting supplemental oxygen therapy to help ease symptoms.