The study also showed that, after six months of anti-TNF therapy (prescribed to control RA inflammation and destruction), a statistically significant improvement in periodontal status was seen in 20 (80%) of the 25 participants (mean age 41.5+3.7 years; mean disease duration 7.2+4.8 years), suggesting that the biological therapy may also be able to modulate the inflammatory process in the periodontium (the tissues investing and supporting the teeth, including the cementum, periodontal ligament, alveolar bone, and gingival / gums).
Dr Codrina Ancuta of the Grigore T Popa University of Medicine and Pharmacy, Rehabilitation Hospital, Iasi, Romania, who led the study, said: "There is a growing body of evidence to demonstrate an association between periodontal disease and systemic conditions involving inflammatory rheumatic disease (especially RA), cardiovascular disease and diabetes. However, further cross-disciplinary research among rheumatologists and periodontologists is required to fully understand the underlying mechanisms that link RA and periodontitis, and to explore how patients can be managed more holistically using treatments such as anti-TNFs and some lifestyle approached that may simultaneously address both conditions."
Moderate to Severe Periodontitis may be a Risk Factor for Developing RA in Non-Smokers
A second study presented at EULAR 2009 showed that, although smoking is an established risk factor for both RA and periodontitis, non-smoking individuals with moderate to severe periodontitis may also be at a greater risk for the development of RA. Those with RA who had moderate to severe periodontitis also developed significantly higher Anti-Citrullinated Peptide Antibody (ACPA) levels than those with no-mild periodontitis.
The retrospective study identified 45 RA patients based on their hospital discharge diagnostic codes from a cohort of 6,661 participants of the Atherosclerosis Risk in Communities (ARIC) study, from whom serum was obtained at the time of a detailed periodontal assessment during the period 1996-1998. RA participant sera were assessed for ACPA and rheumatoid factor (RF) positivity using ELISA (enzyme-linked immunosorbent assay). Participants were classified as having incident RA (n=33) if their first hospital discharge code occurred after periodontitis classification.
The hazard ratio (HR) of developing RA in subjects with moderate to severe periodontitis (n=27) was found to be 2.6 (95% CI=1.0-6.4, p=0.04), compared to those with no / mild periodontitis (n=6). Among lifetime non-smokers who developed RA, the Hazard Ratio was 8.8 (95% CI=1.1-68.9, p=0.04). Periodontitis severity was not shown to be independently associated with RA incidence among current and former smokers. ACPA levels were significantly higher in participants with moderate to severe periodontitis than in those with no / mild periodontitis (222.5 Units vs. 8.4 Units, p=0.04). These findings indicate that periodontitis may be a risk factor both for the development of RA, and for the development of more severe ACPA-positive disease.For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress press office on:
In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems.
The aims of EULAR are to stimulate, promote, and support the research, prevention, treatment and rehabilitation of rheumatic diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with rheumatic diseases.
In 2009, The EULAR Executive Committee launched the EULAR Orphan Disease Programme (ODP) which aims to provide funding to research programmes focused on furthering understanding of the disease mechanisms behind systemic sclerosis. Please see www.eular.org for further information.
Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer.
As new treatments emerge and cellular mechanisms are discovered, EULAR 2009 is set to be the biggest rheumatology event in Europe with over 13,500 scientists, physicians, allied health professionals, and related audiences in attendance from over 100 countries. Over the course of the congress, more than 300 oral and 1,700 poster abstract presentations will be featured, with 780 invited speaker lectures taking place in more than 150 sessions.
Rory Berrie | EurekAlert!
Further reports about: > ACPA > Anti-TNF therapy > CI=1 > EULAR > European League Against Rheumatism > League > RA disease activity > alveolar bone > anti-CCP > cellular mechanism > cementum > chronic inflammatory disease > cyclic citrullinated peptide > healthy matched controls > periodontal ligament > periodontal status > periodontitis > rheumatism > rheumatoid arthritis > risk factor
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