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 Aug 25;33(5):918-927. doi: 10.1093/mr/roac093.
The aim is to evaluate the relevance of serum immunoglobulin G (IgG) titres against periodontopathic bacteria to predict the clinical response to 1-year treatment with biological disease-modifying antirheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) patients.
Data were collected from 50 RA patients who had received conventional synthetic DMARDs, corticosteroids, or non-steroidal anti-inflammatory drugs before (baseline) and after 1-year treatment with bDMARDs in a retrospective cohort study. Changes in rheumatologic conditions were compared between the two groups for low and high baseline IgG titres against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans according to their median measurements.
Twenty-five patients with low anti-P. gingivalis IgG titres showed significantly greater decreases in changes in the Clinical Disease Activity Index and swollen joint count than 25 patients with high anti-P. gingivalis IgG titres (p = .04 for both). Bivariate and multivariate analyses revealed a significantly positive association of baseline anti-P. gingivalis IgG titres with Clinical Disease Activity Index changes (p = .02 and p = .002). However, post-treatment rheumatologic conditions were comparable between 25 patients each in the low and high baseline anti-A. actinomycetemcomitans IgG titre groups.
Baseline serum anti-P. gingivalis IgG titres are predictive of the clinical response to 1-year treatment with bDMARDs in RA patients.
评估针对牙周病细菌的血清 IgG （免疫球蛋白 G）滴度与类风湿关节炎（RA）患者接受生物改善病情抗风湿药物（bDMARD）治疗 1 年的临床反应之间的相关性。
在一项回顾性队列研究中，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 年后接受了常规合成 DMARD、皮质类固醇或非甾体抗炎药治疗。根据中位数测量，比较两组基线时针对牙龈卟啉单胞菌和伴放线放线杆菌 IgG 滴度较低和较高的患者，评估风湿学状况的变化。
25 名基线时抗 P. gingivalis IgG 滴度较低的患者在临床疾病活动指数和肿胀关节计数的变化方面明显较基线时抗 P. gingivalis IgG 滴度较高的患者降低更明显（p 值均为.04）。二元和多元分析显示，基线抗 P. gingivalis IgG 滴度与临床疾病活动指数变化呈显著正相关（p 值分别为.02 和.002）。然而，在低和高基线抗 A. actinomycetemcomitans IgG 滴度组中，每组各有 25 名患者，治疗后的风湿学状况无差异。
基线时血清抗 P. gingivalis IgG 滴度可预测 RA 患者接受 bDMARD 治疗 1 年的临床反应。
