General Dentistry and Clinical Education Unit, Faculty of Dentistry & Medical and Dental Hospital, Niigata University, Niigata, Japan.
Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Mod Rheumatol. 2023 Jan 3;33(1):81-87. doi: 10.1093/mr/roab121.
To assess whether periodontitis severity affects the clinical response to biological disease-modifying antirheumatic drugs (bDMARDs) for 1 year in rheumatoid arthritis (RA) patients.
Data were collected from 50 RA patients who had received corticosteroids, conventional synthetic DMARDs, or non-steroidal anti-inflammatory drugs before (baseline) and after 1 year of bDMARD therapy in a retrospective study. Rheumatologic conditions were compared between the two periodontitis severity groups according to the periodontal inflamed surface area (PISA) or Centers for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) case definitions.
Twenty-eight patients with no or mild periodontitis showed significantly greater decreases in changes in Clinical Disease Activity Index (CDAI) and tender and swollen joint count in comparison to 22 patients with moderate and severe periodontitis (p = .02, p = .01, and p = .03). Both bivariate and multivariate analyses revealed a significantly positive association between the baseline CDC/AAP definitions and CDAI changes (p = .005 and p = .0038). However, rheumatologic conditions were comparable between 25 patients each in the low and high PISA groups.
Baseline periodontitis severity according to the CDC/AAP definitions is associated with the clinical response to bDMARDs for 1 year in RA patients.
评估牙周炎严重程度是否会影响类风湿关节炎（RA）患者接受生物改善病情抗风湿药物（bDMARDs）治疗 1 年后的临床反应。
在一项回顾性研究中，收集了 50 名 RA 患者的数据，这些患者在接受 bDMARD 治疗前（基线）和治疗 1 年后接受了皮质类固醇、传统合成 DMARD 或非甾体抗炎药治疗。根据牙周炎炎症表面面积（PISA）或疾病控制和预防中心（CDC）/美国牙周病学会（AAP）的病例定义，将两个牙周炎严重程度组的风湿学状况进行比较。
与 22 名中重度牙周炎患者相比，无或轻度牙周炎患者的临床疾病活动指数（CDAI）和压痛关节及肿胀关节计数的变化明显更大（p=0.02，p=0.01，p=0.03）。无论是单变量还是多变量分析，都显示基线 CDC/AAP 定义与 CDAI 变化之间存在显著正相关（p=0.005 和 p=0.0038）。然而，根据 PISA 低值和高值分组，每组 25 名患者的风湿学状况相似。
根据 CDC/AAP 定义的基线牙周炎严重程度与 RA 患者接受 bDMARDs 治疗 1 年后的临床反应相关。
