Daniela S Silva, Charlotte de Vries, João Rovisco, Sara Serra, Marta Kaminska, Piotr Mydel, Karin Lundberg, José António P da Silva, Isabel P Baptista
{"title":"The impact of periodontitis and periodontal treatment on rheumatoid arthritis outcomes: an exploratory clinical trial.","authors":"Daniela S Silva, Charlotte de Vries, João Rovisco, Sara Serra, Marta Kaminska, Piotr Mydel, Karin Lundberg, José António P da Silva, Isabel P Baptista","doi":"10.1093/rheumatology/keae358","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Studies suggest RA patients could benefit from periodontal treatment. However, published data are inconsistent, and there is a need for better-controlled research. Our study aims to address these limitations.</p><p><strong>Methods: </strong>In this exploratory randomized delayed-start study, 22 RA patients with moderate/severe periodontitis were subjected to full-mouth debridement. Periodontal and rheumatological assessments, including measuring anti-cyclic citrullinated peptide 2 (CCP2) IgG levels, were performed at baseline (V1), 2 months (V2) and 6 months (V3) after steps 1 and 2 of periodontal therapy. Primary outcome was changes in DAS for 28 joints (DAS28) between V2 and V1. Secondary outcomes were changes in other rheumatological or periodontal clinical parameters (V2 or V3-V1).</p><p><strong>Results: </strong>RA disease activity was significantly higher in RA patients with severe periodontitis compared with moderate periodontitis at baseline, with significant positive correlations between several rheumatological and periodontal parameters. After periodontal treatment, RA patients with severe, but not moderate, periodontitis demonstrated significant improvements in DAS28 (ΔV2-V1, P = 0.042; ΔV3-V1, P = 0.001) and significant reduction in anti-CCP2 IgG levels at V3 (P = 0.032).</p><p><strong>Conclusion: </strong>Periodontal treatment is locally effective in patients with RA and impacts RA disease activity and anti-CCP2 antibody levels in patients with severe periodontitis. Hence, our data suggest that periodontal assessment and treatment should be integrated in the management of RA patients within a treat-to-target strategy.</p><p><strong>Trial registration: </strong>isrctn.com, http://www.isrctn.com, ISRCTN 17950307.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1679-1688"},"PeriodicalIF":4.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/rheumatology/keae358","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Studies suggest RA patients could benefit from periodontal treatment. However, published data are inconsistent, and there is a need for better-controlled research. Our study aims to address these limitations.
Methods: In this exploratory randomized delayed-start study, 22 RA patients with moderate/severe periodontitis were subjected to full-mouth debridement. Periodontal and rheumatological assessments, including measuring anti-cyclic citrullinated peptide 2 (CCP2) IgG levels, were performed at baseline (V1), 2 months (V2) and 6 months (V3) after steps 1 and 2 of periodontal therapy. Primary outcome was changes in DAS for 28 joints (DAS28) between V2 and V1. Secondary outcomes were changes in other rheumatological or periodontal clinical parameters (V2 or V3-V1).
Results: RA disease activity was significantly higher in RA patients with severe periodontitis compared with moderate periodontitis at baseline, with significant positive correlations between several rheumatological and periodontal parameters. After periodontal treatment, RA patients with severe, but not moderate, periodontitis demonstrated significant improvements in DAS28 (ΔV2-V1, P = 0.042; ΔV3-V1, P = 0.001) and significant reduction in anti-CCP2 IgG levels at V3 (P = 0.032).
Conclusion: Periodontal treatment is locally effective in patients with RA and impacts RA disease activity and anti-CCP2 antibody levels in patients with severe periodontitis. Hence, our data suggest that periodontal assessment and treatment should be integrated in the management of RA patients within a treat-to-target strategy.
期刊介绍：
Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press.
Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.
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