Periodontal disease is significantly higher in non-smoking treatment-naive rheumatoid arthritis patients: results from a case-control study

• Published in: Annals of the rheumatic diseases Vol. 71; no. 9; pp. 1541 - 1544
• Main Authors: Potikuri, Damodaram, Dannana, Kalyan Chakravarthy, Kanchinadam, Suresh, Agrawal, Sumeet, Kancharla, Anuradha, Rajasekhar, Liza, Pothuraju, Shantakumari, Gumdal, Narsimulu
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.09.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - immunology; Autoantibodies - blood; Biological and medical sciences; Case-Control Studies; Diseases of the osteoarticular system; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Humans; Hypotheses; Inflammation; Inflammatory joint diseases; Male; Medical sciences; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pathogenesis; Peptides; Periodontal Diseases - complications; Protein folding; Rheumatism; Rheumatoid arthritis; Rheumatology; Smoking; Smoking - immunology; Studies; Tobacco; Tobacco, tobacco smoking; Toxicology; Variables; Human; Immunopathology; Stomatology; Diseases of the osteoarticular system; Rheumatology; Tobacco smoking; Autoimmune disease; Inflammatory joint disease; Case control study; Chronic; Periodontal disease; Treatment; Rheumatoid arthritis
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2011-200380

Objective To find the strength of association between periodontal disease (PD) and rheumatoid arthritis (RA) in non-smoking, disease modifying antirheumatic drug (DMARD)-naive RA patients in a case-control design. Methods Patients of RA (DMARD-naive, non-smokers) satisfying the American college of Rheumatology 1987 criteria and healthy controls were included. PD was defined as present if the mean pocket depth (MPD) is ≥3 mm. Demographic data and disease specific variables were recorded for RA patients and healthy controls. Titres of immunoglobulin M-rheumatoid factor (IgM-RF) and anticitrullinated peptide antibodies (ACPAs) were measured using ELISA. Results Patients with RA (n=91) had a 4.28 (CI 2.35 to 7.38) higher odds of PD (64.8% vs 28%, p<0.001) compared with healthy controls (n=93). The MPD was 3.61±1.22 mm in cases and 2.46±0.74 mm in controls (p<0.001). IgM-RF titres (110.56±95.81 vs 66.53±70.29; p=0.02) and ACPA titres (753.05±1088.27 vs 145.15±613.16, p=0.001) were significantly higher in RA patients with PD than those without PD. The MPD positively correlated with titres of ACPAs in RA patients (r=0.24; p=0.02). Conclusions PD is more frequent and severe in non-smoking DMARD-naive RA patients compared with healthy controls. PD in RA is associated with high titres of ACPAs.