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

Author

Listed:
  • Menke J. de Smit

    (Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
    Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
    Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands)

  • Johanna Westra

    (Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands)

  • Marcel D. Posthumus

    (Department of Internal Medicine and Rheumatology, Martini Hospital Groningen, Van Swietenplein 1, 9728 NT Groningen, The Netherlands)

  • Gerald Springer

    (Department of Oral and Maxillofacial Surgery, Martini Hospital Groningen, Van Swietenplein 1, 9728 NT Groningen, The Netherlands)

  • Arie Jan van Winkelhoff

    (Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands)

  • Arjan Vissink

    (Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands)

  • Elisabeth Brouwer

    (Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands)

  • Marc Bijl

    (Department of Internal Medicine and Rheumatology, Martini Hospital Groningen, Van Swietenplein 1, 9728 NT Groningen, The Netherlands)

Abstract

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.

Suggested Citation

  • Menke J. de Smit & Johanna Westra & Marcel D. Posthumus & Gerald Springer & Arie Jan van Winkelhoff & Arjan Vissink & Elisabeth Brouwer & Marc Bijl, 2021. "Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients," IJERPH, MDPI, vol. 18(5), pages 1-9, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2529-:d:510049
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    Cited by:

    1. Poerwati S. Rahajoe & Menke J. de Smit & Elisabeth Raveling-Eelsing & Marines du Teil Espina & Tim Stobernack & Paola Lisotto & Hermie J. M. Harmsen & Jan Maarten van Dijl & Nyoman Kertia & Arjan Viss, 2021. "No Obvious Role for Suspicious Oral Pathogens in Arthritis Development," IJERPH, MDPI, vol. 18(18), pages 1-11, September.

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