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Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients

Periodontitis, a bacterial-induced infection of the supporting soft and hard tissues of the teeth (the periodontium), is common in patients with rheumatoid arthritis (RA). As RA and periodontitis underlie common inflammatory pathways, targeting the progression of RA might mediate both periodontitis...

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Autores principales: de Smit, Menke J., Westra, Johanna, Posthumus, Marcel D., Springer, Gerald, van Winkelhoff, Arie Jan, Vissink, Arjan, Brouwer, Elisabeth, Bijl, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967392/
https://www.ncbi.nlm.nih.gov/pubmed/33806304
http://dx.doi.org/10.3390/ijerph18052529
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author de Smit, Menke J.
Westra, Johanna
Posthumus, Marcel D.
Springer, Gerald
van Winkelhoff, Arie Jan
Vissink, Arjan
Brouwer, Elisabeth
Bijl, Marc
author_facet de Smit, Menke J.
Westra, Johanna
Posthumus, Marcel D.
Springer, Gerald
van Winkelhoff, Arie Jan
Vissink, Arjan
Brouwer, Elisabeth
Bijl, Marc
author_sort de Smit, Menke J.
collection PubMed
description Periodontitis, a bacterial-induced infection of the supporting soft and hard tissues of the teeth (the periodontium), is common in patients with rheumatoid arthritis (RA). As RA and periodontitis underlie common inflammatory pathways, targeting the progression of RA might mediate both periodontitis and RA. On the other hand, patients with RA on immunosuppressive medication have an increased risk of infection. Therefore, the objective of this longitudinal observation study was to assess the effect of methotrexate (MTX) and anti-tumor necrosis factor-α (anti-TNF, etanercept) treatment on the periodontal condition of RA patients. Overall, 14 dentate treatment-naive RA patients starting with MTX and 12 dentate RA patients starting with anti-TNF therapy in addition to MTX were included. Follow-up was scheduled matching the routine protocol for the respective treatments. Prior to the anti-rheumatic treatment with MTX or the anti-TNF therapy in addition to MTX, and during follow-up, i.e., 2 months for MTX, and 3 and 6 months for the anti-TNF therapy in addition to MTX, the periodontal inflamed surface area (PISA) was measured. The efficacy of the anti-rheumatic treatment was assessed by determining the change in RA disease activity (DAS28-ESR). Furthermore, the erythrocyte sedimentation rates were determined and the levels of C-reactive protein, IgM-rheumatoid factor, anti-cyclic citrullinated protein antibodies, and antibodies to the periodontal pathogen Porphyromonas gingivalis, were measured. Subgingival sampling and microbiological characterization of the subgingival microflora was done at baseline. MTX or anti-TNF treatment did not result in an improvement of the periodontal condition, while both treatments significantly improved DAS28 scores (both p < 0.01), and reduced C-reactive protein levels and erythrocyte sedimentation rates (both p < 0.05). It is concluded that anti-rheumatic treatment (MTX and anti-TNF) has negligible influence on the periodontal condition of RA patients.
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spelling pubmed-79673922021-03-18 Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients de Smit, Menke J. Westra, Johanna Posthumus, Marcel D. Springer, Gerald van Winkelhoff, Arie Jan Vissink, Arjan Brouwer, Elisabeth Bijl, Marc Int J Environ Res Public Health Article Periodontitis, a bacterial-induced infection of the supporting soft and hard tissues of the teeth (the periodontium), is common in patients with rheumatoid arthritis (RA). As RA and periodontitis underlie common inflammatory pathways, targeting the progression of RA might mediate both periodontitis and RA. On the other hand, patients with RA on immunosuppressive medication have an increased risk of infection. Therefore, the objective of this longitudinal observation study was to assess the effect of methotrexate (MTX) and anti-tumor necrosis factor-α (anti-TNF, etanercept) treatment on the periodontal condition of RA patients. Overall, 14 dentate treatment-naive RA patients starting with MTX and 12 dentate RA patients starting with anti-TNF therapy in addition to MTX were included. Follow-up was scheduled matching the routine protocol for the respective treatments. Prior to the anti-rheumatic treatment with MTX or the anti-TNF therapy in addition to MTX, and during follow-up, i.e., 2 months for MTX, and 3 and 6 months for the anti-TNF therapy in addition to MTX, the periodontal inflamed surface area (PISA) was measured. The efficacy of the anti-rheumatic treatment was assessed by determining the change in RA disease activity (DAS28-ESR). Furthermore, the erythrocyte sedimentation rates were determined and the levels of C-reactive protein, IgM-rheumatoid factor, anti-cyclic citrullinated protein antibodies, and antibodies to the periodontal pathogen Porphyromonas gingivalis, were measured. Subgingival sampling and microbiological characterization of the subgingival microflora was done at baseline. MTX or anti-TNF treatment did not result in an improvement of the periodontal condition, while both treatments significantly improved DAS28 scores (both p < 0.01), and reduced C-reactive protein levels and erythrocyte sedimentation rates (both p < 0.05). It is concluded that anti-rheumatic treatment (MTX and anti-TNF) has negligible influence on the periodontal condition of RA patients. MDPI 2021-03-04 /pmc/articles/PMC7967392/ /pubmed/33806304 http://dx.doi.org/10.3390/ijerph18052529 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
de Smit, Menke J.
Westra, Johanna
Posthumus, Marcel D.
Springer, Gerald
van Winkelhoff, Arie Jan
Vissink, Arjan
Brouwer, Elisabeth
Bijl, Marc
Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients
title Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients
title_full Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients
title_fullStr Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients
title_full_unstemmed Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients
title_short Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients
title_sort effect of anti-rheumatic treatment on the periodontal condition of rheumatoid arthritis patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967392/
https://www.ncbi.nlm.nih.gov/pubmed/33806304
http://dx.doi.org/10.3390/ijerph18052529
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