title: Risk of incident chronic obstructive pulmonary disease in patients with rheumatoid arthritis: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the risk of subsequent development of chronic obstructive pulmonary disease (COPD) in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  We conducted a systematic review and meta-analysis of cohort studies that reported relative risk, hazard ratio or standardized incidence ratio with 95% confidence interval (CI), comparing risk of incident COPD in patients with RA versus non-RA participants. Pooled risk ratio and 95% CI were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.
  
  
  RESULTS
  Four retrospective cohort studies with 32,675 patients with RA and 122,204 controls were included in the data analysis. The pooled risk ratio of incident COPD in patients with RA versus control was 1.99 (95% CI, 1.61-2.45). The statistical heterogeneity was high with an I2 of 81%.
  
  
  CONCLUSIONS
  Our study demonstrated a statistically significant increased risk of subsequent development of COPD among patients with RA.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA; Department of Medicine, Faculty of medicine Siriraj hospital, Mahidol University, Bangkok 10700, Thailand. Electronic address: p.ungprasert@gmail.com.
authors.forename: Patompong
authors.initials: P
authors.lastname: Ungprasert
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Narat
authors.initials: N
authors.lastname: Srivali
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Wisit
authors.initials: W
authors.lastname: Cheungpasitporn
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Davis Iii
mesh_terms: D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012307:Risk Factors
keywords: COPD; Epidemiology; Meta-analysis; Rheumatoid arthritis