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Periodontitis more prevalent in patients with rheumatoid arthritis
Patients with rheumatoid arthritis had an increased risk for severe and moderate periodontitis compared with controls, according to study results.
Researchers in the Netherlands studied 95 patients (68% women) with rheumatoid arthritis (RA) and 80 controls, including non-RA controls (n=44; 57% women) for blood and subgingival samples, matched for age, gender, BMI, periodontal and smoking status, and healthy controls (n=36; 56% women) with no periodontitis or cultivable Porphyromonas gingivalis. The Dutch Periodontal Screening Index was used to examine periodontal conditions and treatment needs, and anaerobic cultures were used to test subgingival plaque samples for P. gingivalis. ELISA measured IgA, IgG and IgM antibody titers to P. gingivalis. A general control group of 420 non-RA patients (68% women) was compared to the RA patients using serum and subgingival plaque measures.
RA patients had a higher prevalence of severe periodontitis compared with the 420 controls (27% vs. 12%; RR=3.7; 95% CI, 2.4-5.9). Those with RA also had a significantly higher rate for moderate periodontitis (43% vs. 18%; RR=3.6; 95% CI, 2.3-5.5). Compared with RA patients with no or moderate periodontitis, RA patients with severe periodontitis had higher Disease Activity Score 28 (P<.001); there were no differences on IgM-RF or anti citrullinated protein antibodies reactivity. Compared with non-RA controls with severe periodontitis, the patients with RA and severe periodontitis had higher IgG- and IgM-anti P. gingivalis titers (P<.01 and P<.05, respectively); subgingival occurrence of P. gingivalis displayed no difference.
“Importantly, serological markers for systemic inflammation of periodontal origin further substantiated the connection of [RA and periodontitis], in terms of higher antibody titers against P. gingivalis in RA patients with severe periodontitis, compared to severe periodontitis patients without RA,” the researchers said. “These differences cannot be explained by differences in P. gingivalis colonization, since the distribution of RA and non-RA patients was similar.”