The following is a summary of “Impact of periodontitis and periodontal treatment on rheumatoid arthritis outcomes: an exploratory clinical trial,” published in the July 2024 issue of Rheumatology by Silva et al.

Studies indicate that patients with rheumatoid arthritis (RA) may gain advantages from periodontal therapy, though existing data is varied.

Researchers conducted a retrospective study evaluating the impact of periodontal treatment on patients with RA.

They subjected 22 patients with RA with moderate to severe periodontitis who had undergone full-mouth debridement. Assessments of periodontal and rheumatological health, which included the measurement of anti-cyclic citrullinated peptide 2 (CCP2) IgG levels, were carried out at baseline (V1) as well as at 2 months (V2) and 6 months (V3) following the initial 2 steps of periodontal treatment. The change in the disease activity score for 28 joints (DAS28) from V1 to V2 was assessed as the primary outcome, while secondary outcomes included alterations in various rheumatological and periodontal clinical parameters measured at V2 and V3 compared to V1.

The result showed that disease activity in patients with RA was significantly higher in individuals with severe periodontitis compared to patients with moderate periodontitis, and strong positive associations were observed among multiple rheumatological and periodontal factors. After undergoing periodontal treatment, patients with severe periodontitis showed considerable improvements in the DAS28 score (ΔV2-V1, P=0.042; ΔV3-V1, P=0.001) and a significant decrease in anti-CCP2 IgG levels at V3 (P=0.032).

Investigators concluded that periodontal treatment proved locally beneficial for patients with RA, influencing disease activity and anti-CCP2 antibody levels in patients with severe periodontitis, suggesting the inclusion of a treat-to-target approach for managing RA.

Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae358/7713375