Egle Punceviciene1,2,3, Adomas Rovas4,5, Alina Puriene4,5, Kristina Stuopelyte6,7, Dalius Vitkus8,9, Sonata Jarmalaite6,7, Irena Butrimiene10,11,12. 1. Clinic of Rheumatology, Traumatology Orthopaedics and Reconstructive Surgery, Institute of Clinical Medicine of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania. epunceviciene@gmail.com. 2. Centre of Rheumatology, Vilnius University Hospital Santaros klinikos, Santariškių str. 2, LT-08661, Vilnius, Lithuania. epunceviciene@gmail.com. 3. State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania. epunceviciene@gmail.com. 4. Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. 5. Vilnius University Hospital Zalgiris Clinic, Vilnius, Lithuania. 6. Institute of Biosciences, Life Sciences Centre, Vilnius University, Vilnius, Lithuania. 7. National Cancer Institute, Vilnius, Lithuania. 8. Institute of Biomedical Sciences of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania. 9. Centre of Laboratory Medicine, Vilnius University Hospital Santaros klinikos, Vilnius, Lithuania. 10. Clinic of Rheumatology, Traumatology Orthopaedics and Reconstructive Surgery, Institute of Clinical Medicine of the Faculty of Medicine, Vilnius University, Vilnius, Lithuania. 11. Centre of Rheumatology, Vilnius University Hospital Santaros klinikos, Santariškių str. 2, LT-08661, Vilnius, Lithuania. 12. State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania.
Abstract
OBJECTIVES: This paper evaluates the prevalence and severity of periodontitis (PD) in patients with rheumatoid arthritis (RA), focusing on the link between the severity of PD with RA disease activity/disability scores, the influence of RA treatment on PD, and levels of vitamin D. METHODS: A total of 93 RA patients were enrolled in the cross-sectional study and analyzed accordingly as RA-PD (N = 63, 67.8%) and RA-only (N = 30, 32.2%) groups. A number of associations between rheumatological clinical data, i.e., Disease Activity Score (DAS28 CRP), health assessment questionnaires, and PD severity (measured by periodontal outcome parameters) with regard to serum levels of vitamin D were assessed. The outcome variables were compared by parametric and non-parametric tests. RESULTS: A total of 29% of RA patients were diagnosed with severe PD. The RA-PD group presented a higher mean DAS28 CRP score in moderate-severe PD compared to periodontally healthy-initial stage PD subjects (4.49 ± 1.22 vs. 3.86 ± 1.58, p = 0.033). RA patients treated with biologic disease-modifying antirheumatic drugs (bDMARDs) were less likely to be diagnosed with PD (p = 0.022) and revealed significantly lower PD outcome parameters, i.e., bleeding on probing (%) and bone loss (%) (p < 0.05). Vitamin D concentration was significantly lower in RA-PD group with diagnosed advanced severe PD (IV stage) compared to moderate PD (II stage) (39.61 ± 17.12 vs. 52.07 ± 18.23 nmol/l, p = 0.031). CONCLUSIONS: The study revealed a high prevalence of severe PD in RA patients, being significantly associated with higher RA disease activity and lower vitamin D level in RA-PD group, while bDMARD treatment was related to lower PD outcome parameters. Key Points • Severe PD is prevalent amongst RA patients and is associated with RA disease activity. The higher RA DAS28 CRP score is associated with moderate-severe PD compared to periodontally healthy-initial stage PD in RA patients. • Biologic DMARDs treatment used for RA is linked to lower PD rates and PD outcome parameters. • Significantly lower vitamin D level is found in advanced severe PD compared to moderate PD stage in RA-PD subjects.
OBJECTIVES: This paper evaluates the prevalence and severity of periodontitis (PD) in patients with rheumatoid arthritis (RA), focusing on the link between the severity of PD with RA disease activity/disability scores, the influence of RA treatment on PD, and levels of vitamin D. METHODS: A total of 93 RApatients were enrolled in the cross-sectional study and analyzed accordingly as RA-PD (N = 63, 67.8%) and RA-only (N = 30, 32.2%) groups. A number of associations between rheumatological clinical data, i.e., Disease Activity Score (DAS28 CRP), health assessment questionnaires, and PD severity (measured by periodontal outcome parameters) with regard to serum levels of vitamin D were assessed. The outcome variables were compared by parametric and non-parametric tests. RESULTS: A total of 29% of RApatients were diagnosed with severe PD. The RA-PD group presented a higher mean DAS28 CRP score in moderate-severe PD compared to periodontally healthy-initial stage PD subjects (4.49 ± 1.22 vs. 3.86 ± 1.58, p = 0.033). RApatients treated with biologic disease-modifying antirheumatic drugs (bDMARDs) were less likely to be diagnosed with PD (p = 0.022) and revealed significantly lower PD outcome parameters, i.e., bleeding on probing (%) and bone loss (%) (p < 0.05). Vitamin D concentration was significantly lower in RA-PD group with diagnosed advanced severe PD (IV stage) compared to moderate PD (II stage) (39.61 ± 17.12 vs. 52.07 ± 18.23 nmol/l, p = 0.031). CONCLUSIONS: The study revealed a high prevalence of severe PD in RApatients, being significantly associated with higher RA disease activity and lower vitamin D level in RA-PD group, while bDMARD treatment was related to lower PD outcome parameters. Key Points • Severe PD is prevalent amongst RApatients and is associated with RA disease activity. The higher RA DAS28 CRP score is associated with moderate-severe PD compared to periodontally healthy-initial stage PD in RApatients. • Biologic DMARDs treatment used for RA is linked to lower PD rates and PD outcome parameters. • Significantly lower vitamin D level is found in advanced severe PD compared to moderate PD stage in RA-PD subjects.
Authors: Maximilian F Konig; Loreto Abusleme; Jesper Reinholdt; Robert J Palmer; Ricardo P Teles; Kevon Sampson; Antony Rosen; Peter A Nigrovic; Jeremy Sokolove; Jon T Giles; Niki M Moutsopoulos; Felipe Andrade Journal: Sci Transl Med Date: 2016-12-14 Impact factor: 17.956
Authors: Addie Dissick; Robert S Redman; Miata Jones; Bavana V Rangan; Andreas Reimold; Garth R Griffiths; Ted R Mikuls; Richard L Amdur; John S Richards; Gail S Kerr Journal: J Periodontol Date: 2010-02 Impact factor: 6.993
Authors: Leena Äyräväinen; Marjatta Leirisalo-Repo; Antti Kuuliala; Kirsi Ahola; Riitta Koivuniemi; Jukka H Meurman; Anna Maria Heikkinen Journal: BMJ Open Date: 2017-01-31 Impact factor: 2.692
Authors: Menke de Smit; Johanna Westra; Arjan Vissink; Berber Doornbos-van der Meer; Elisabeth Brouwer; Arie Jan van Winkelhoff Journal: Arthritis Res Ther Date: 2012-10-17 Impact factor: 5.156
Authors: Kaja Eriksson; Lena Nise; Anna Kats; Elin Luttropp; Anca Irinel Catrina; Johan Askling; Leif Jansson; Lars Alfredsson; Lars Klareskog; Karin Lundberg; Tülay Yucel-Lindberg Journal: PLoS One Date: 2016-05-20 Impact factor: 3.240
Authors: Kaja Eriksson; Anna Lundmark; Luis F Delgado; Yue O O Hu; Guozhong Fei; Linkiat Lee; Carina Fei; Anca I Catrina; Leif Jansson; Anders F Andersson; Tülay Yucel-Lindberg Journal: Front Cell Infect Microbiol Date: 2022-03-14 Impact factor: 5.293