<--GAT-->
Current Issue

Target Lung Disease to Improve Rheumatoid Arthritis Survival

by U.S. Medicine

February 2, 2019

OMAHA, NE – A recent VA study emphasized the importance of targeting comorbid lung disease to improve long-term outcomes in rheumatoid arthritis (RA).

The report in Clinical Rheumatology discussed the effect of chronic lung diseases (CLD) on survival in RA.1

A study team led by researchers from the Nebraska-Western Iowa VA Healthcare System identified CLD and cardiovascular disease in participants in the Veterans Affairs Rheumatoid Arthritis (VARA) Registry.

Among the information collected was demographics, smoking status, RA characteristics including Disease Activity Score in 28 joints (DAS28), and disease-modifying anti-rheumatic drug (DMARD) use.

The study team  evaluated associations of CLD with survival using the multivariable Cox regression models. Among  the 2,053 mostly male RA cohort, 554 (27%) had CLD at enrollment.

Researchers determined that mortality risk was increased 1.51-fold (95% CI 1.26-1.81) in RA patients with CLD after multivariable adjustment, a risk that was similar to that observed with CVD (HR CLD alone 1.46 [1.03-2.06]; CVD alone 1.62 [1.35-1.94]).

In addition, the study documented that survival was significantly reduced in those with interstitial lung disease (ILD) as well as other forms of CLD.

On the other hand, mortality risk with methotrexate and biologic use was not different in those with CLD compared to those without (p interaction ≥ 0.15) using multiple exposure definitions and propensity score adjustment.

“Mortality risk is significantly increased in RA patients with CLD,” study authors concluded. “This risk is attributable not only to ILD but also to other chronic lung conditions and does not appear to be substantially greater in those receiving methotrexate or biologic therapies. Comorbid lung disease should be targeted as a means of improving long-term outcomes in RA.”

1. England BR, Sayles H, Michaud K, Thiele GM, Poole JA, Caplan L, Sauer BC, Cannon GW, Reimold A, Kerr GS, Baker JF, Mikuls TR. Chronic lung disease in U.S. Veterans with rheumatoid arthritis and the impact on survival. Clin Rheumatol. 2018 Nov;37(11):2907-2915. doi: 10.1007/s10067-018-4314-9. Epub 2018 Oct 2. PubMed PMID: 30280369.



Related Articles

VA Overall Appointment Wait Times Shorter than the Private-Sector

Despite intense scrutiny of wait times for veterans seeking VA care over the last three years, a new study pointed out that delays in the private sector weren’t statistically less in 2014 and that, possibly because of the focus, wait times now are significantly shorter for the VA compared to private-sector healthcare facilities.

Senate Blocks Agent Orange Exposure Extension to Blue Water Veterans

Blue Water Navy veterans who claim to be impacted by toxic exposure while serving off the coast of Vietnam were forced to grapple with disappointment once again as the 115th Congress ended without passing legislation addressing their VA benefits.


U.S. Medicine Recommends


More From current issue

Current Issue

VA Overall Appointment Wait Times Shorter than the Private-Sector

Despite intense scrutiny of wait times for veterans seeking VA care over the last three years, a new study pointed out that delays in the private sector weren’t statistically less in 2014 and that, possibly because of the focus, wait times now are significantly shorter for the VA compared to private-sector healthcare facilities.

Current Issue

Senate Blocks Agent Orange Exposure Extension to Blue Water Veterans

Blue Water Navy veterans who claim to be impacted by toxic exposure while serving off the coast of Vietnam were forced to grapple with disappointment once again as the 115th Congress ended without passing legislation addressing their VA benefits.

Current Issue

VA Seeks to Resolve Questions about Prazosin for PTSD Nightmares

For years, prazosin has appeared to be one of the most effective medications for treating the nightmares associated with post-traumatic stress disorder, but that treatment is being called into questions by findings from two recent studies that patients with PTSD who received a placebo did as well or better than those who received prazosin.

Current Issue

Most Veterans Receiving VA Mental Healthcare Support Some Gun Restrictions

A survey of veterans receiving mental healthcare through VA found that the vast majority would favor at least one option to restrict firearm access with the goal of reducing dangers of self-harm.

Current Issue

“An investment in knowledge pays the best interest.” –Benjamin Franklin (1706-1790)

SEATTLE–For years, prazosin has appeared to be one of the most effective medications for treating the nightmares associated with post-traumatic stress disorder, but that treatment is being called into questions by  findings from two recent... View Article

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up