Highlights
- •In this population-based cross sectional study AS has been shown to be associated with increased risk of COPD.
- •Smoking or the underlying pro-inflammatory milieu in AS could plausibly account for this association.
- •Smoking cessation should be encouraged in AS patients, and COPD screening may be warranted.
Abstract
Background
Ankylosing spondylitis (AS) is one of the most common and severe subtypes of the spondyloarthropathies.
Extra-articular involvement among AS patients, including lung disease, has been described
widely. Chronic obstructive pulmonary disease (COPD) has been linked to several autoimmune
diseases, however, very few studies have investigated the association between AS and
COPD.
Objective
To assess whether an association exists between AS and COPD.
Material and methods
A population-based cross-sectional study was conducted using data retrieved from the
largest electronic medical records database in Israel, the Clalit Health Services
(CHS). Patients were defined as having AS or COPD when there was at least one such
documented diagnosis in their medical records. The proportion of COPD was compared
between AS patients and controls. A logistic regression model was used to estimate
the association between AS and COPD in a multivariate analysis adjusted for age, gender
and smoking status.
Results
The study included 4076 patients with AS and 20,290 age- and sex-frequency matched
controls. The proportion of COPD in AS patients was higher than in controls (46% vs.
18%, respectively, p < .001). Multivariate logistic regression demonstrated a robust independent association
between AS and COPD (OR 1.225, p = .031).
Conclusion
Our study supports an association between AS and COPD, further extending the link
between COPD and autoimmune diseases. This finding highlights the importance of smoking
cessation in AS patients and raises the question of whether COPD screening may be
warranted.
Keywords
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Article info
Publication history
Published online: April 06, 2018
Accepted:
April 2,
2018
Received in revised form:
October 14,
2017
Received:
July 10,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
