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Current Respiratory Medicine Reviews

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ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

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Research Article

Deteriorating Pulmonary Functions in Patients with Rheumatoid Arthritis- A Pilot Study from South India

Author(s): Vijayabaskaran Shanmugavaradharajan*, Rajesh NT, Divya R and Damodaran Vasudevan

Volume 20, Issue 1, 2024

Published on: 01 January, 2024

Page: [72 - 78] Pages: 7

DOI: 10.2174/011573398X278585231221052355

Price: $65

Abstract

Background and Objective: Pulmonary involvement is a common extra-articular manifestation of rheumatoid arthritis (RA). The present study attempts to highlight the extent of involvement by assessing lung function using pulmonary function tests (PFTs) in patients with RA.

Methods: This pilot study involved 30 patients with RA and an equal number of age- and sexmatched healthy controls. All the study participants were subjected to spirometry and in RA patients, the test was repeated after 30 minutes of administering 400 mcg of salbutamol. PFT values of the controls and the pre and post-values of cases like forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), Percentage of forced expiratory volume in the first second (FEV1%), forced expiratory flow at 25% to 75% of the lung volume (FEF25-75%) and peak expiratory flow rate (PEFR) were recorded. Independent sample t-test or Mann-Whitney U test were used for comparisons. The pre- and post-values of PFT were compared using paired t-test, Welsch’s test, or Wilcoxon tests. (p ≤ 0.05 implied statistical significance).

Results: PFT variables were significantly lower among patients with RA compared with controls (p<0.05). A significant negative correlation of FEF25%-75% and PEFR with BMI in obese patients (BMI >23) and FVC, FEV1, and PEFR significantly lower in post-menopausal women (p < 0.05) was seen.

Conclusion: Based on the pilot study findings, patients in south India with RA could manifest decreased pulmonary functions. Obese patients and post-menopausal females with RA could be at a higher risk, and the administration of nebulized salbutamol could improve pulmonary functions.

Keywords: Rheumatoid arthritis, pulmonary function tests, body mass index, arthritis, lungs, joints.

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[1]
Al-Assadi T, Al-Shemery A, Salman S. Correlation of lung function with disease activity rheumatoid arthritis. Oman Med J 2009; 24(2): 84-8.
[http://dx.doi.org/10.5001/omj.2009.20] [PMID: 22334850]
[2]
Kadhum HJ, Al Hamza AN, Bader A. Pattern of pulmonary function test in rheumatoid arthritis patients. Med J Basrah Univ 2017; 35(2): 109-15.
[http://dx.doi.org/10.33762/mjbu.2017.134541]
[3]
Singh S, Lihite RJ, Baruah C, Lahkar M, Singh PK. A pilot study ofcomorbidities in patients with rheumatoid arthritis at a tertiary care hospital in Northeast India. Biomed Res Ther 2016; 3(1): 1.
[http://dx.doi.org/10.7603/s40730-016-0001-0]
[4]
Roy AN, Yadav BS, Fatima S. A cross-sectional study of different rheumatic diseases and their respective comorbidities at a tertiary care hospital in India. Indian J Rheumatol 2019; 14(1): 42-8.
[http://dx.doi.org/10.4103/injr.injr_112_18]
[5]
Richard AW. Comorbidities of rheumatic disease Oxford textbook of rheumatology. (4th ed.), Cham, Switzerland: Oxford University Press 2015.
[6]
Watson DJ, Rhodes T, Guess HA. All-cause mortality and vascular events among patients with rheumatoid arthritis, osteoarthritis, or no arthritis in the UK General Practice Research Database. J Rheumatol 2003; 30(6): 1196-202.
[PMID: 12784389]
[7]
Gonzalez A, Maradit Kremers H, Crowson CS, et al. The widening mortality gap between rheumatoid arthritis patients and the general population. Arthritis Rheum 2007; 56(11): 3583-7.
[http://dx.doi.org/10.1002/art.22979] [PMID: 17968923]
[8]
Anaya JM, Diethelm L, Ortiz LA, et al. Pulmonary involvement in rheumatoid arthritis. Semin Arthritis Rheum 1995; 24(4): 242-54.
[http://dx.doi.org/10.1016/S0049-0172(95)80034-4] [PMID: 7740304]
[9]
Cortet B, Perez T, Roux N, et al. Pulmonary function tests and high resolution computed tomography of the lungs in patients with rheumatoid arthritis. Ann Rheum Dis 1997; 56(10): 596-600.
[http://dx.doi.org/10.1136/ard.56.10.596] [PMID: 9389220]
[10]
Ranu H, Wilde M, Madden B. Pulmonary function tests. Ulster Med J 2011; 80(2): 84-90.
[PMID: 22347750]
[11]
Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: An american college of rheumatology/european league against rheumatism collaborative initiative. Arthritis Rheum 2010; 62(9): 2569-81.
[http://dx.doi.org/10.1002/art.27584] [PMID: 20872595]
[12]
Pappas DA, Giles JT, Connors G, Lechtzin N, Bathon JM, Danoff SK. Respiratory symptoms and disease characteristics as predictors of pulmonary function abnormalities in patients with rheumatoid arthritis: An observational cohort study. Arthritis Res Ther 2010; 12(3): R104.
[http://dx.doi.org/10.1186/ar3037] [PMID: 20507627]
[13]
Hassan WU, Keaney NP, Holland CD, Kelly CA. Bronchial reactivity and airflow obstruction in rheumatoid arthritis. Ann Rheum Dis 1994; 53(8): 511-4.
[http://dx.doi.org/10.1136/ard.53.8.511] [PMID: 7944635]
[14]
Gerosa M, De Angelis V, Riboldi P, Meroni PL. Rheumatoid arthritis: A female challenge. Womens Health 2008; 4(2): 195-201.
[http://dx.doi.org/10.2217/17455057.4.2.195] [PMID: 19072521]
[15]
Fuld JP, Johnson MK, Cotton MM, et al. A longitudinal study of lung function in nonsmoking patients with rheumatoid arthritis. Chest 2003; 124(4): 1224-31.
[http://dx.doi.org/10.1378/chest.124.4.1224] [PMID: 14555550]
[16]
Shaw M, Collins BF, Ho LA, Raghu G. Rheumatoid arthritis-associated lung disease. Eur Respir Rev 2015; 24(135): 1-16.
[http://dx.doi.org/10.1183/09059180.00008014] [PMID: 25726549]
[17]
Kawamura T, Mochizuki Y, Nakahara Y, Watanabe S, Sasaki S, Kobashi Y. [A case of rheumatoid lung disease in which lung involvement preceded arthritis]. Japanese Respiratory Society Magazine 2001; 39(2): 131-4. [Japanese].
[PMID: 11321825]
[18]
Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018; 12(9): 755-67.
[http://dx.doi.org/10.1080/17476348.2018.1506331] [PMID: 30056777]
[19]
Triebner K, Matulonga B, Johannessen A, et al. Menopause is associated with accelerated lung function decline. Am J Respir Crit Care Med 2017; 195(8): 1058-65.
[http://dx.doi.org/10.1164/rccm.201605-0968OC] [PMID: 27907454]
[20]
Madhavan S, Kingsley CT, Anandan H. Correlation of pulmonary function with rheumatoid arthritis disease activity. Int J Contemp Med 2017; 4(9): 2000-3.
[21]
Visser R, Kelderman S, de Jongh FHC, van der Palen J, Thio BJ. Reversibility of pulmonary function after inhaling salbutamol in different doses and body postures in asthmatic children. Respir Med 2015; 109(10): 1274-9.
[http://dx.doi.org/10.1016/j.rmed.2015.07.015] [PMID: 26341548]
[22]
Aliverti A, Rodger K, Dellacà RL, et al. Effect of salbutamol on lung function and chest wall volumes at rest and during exercise in COPD. Thorax 2005; 60(11): 916-24.
[http://dx.doi.org/10.1136/thx.2004.037937] [PMID: 15994253]
[23]
American Thoracic Society. ATS standardization of spirometry: 1994 update. Am J Respir Crit Care Med 1994; 152: 1107-36.
[24]
Pauwels RA, Buist AS, Calverley PMA, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO global initiative for chronic obstructive lung disease (GOLD) workshop summary. Am J Respir Crit Care Med 2001; 163(5): 1256-76.
[http://dx.doi.org/10.1164/ajrccm.163.5.2101039] [PMID: 11316667]

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