Friday, 23 Aug 2019

You are here

Periodontal Disease and P. gingivalis Increased in CCP+ Pre-Clinical RA

A cross-sectional study 48 CCP–positive "at risk" individuals (without arthritis) were shown to have an increased prevalence of periodontitis and P gingivalis when compared to 26 early RA (ERA) and 32 controls.

anti–cyclic citrullinated protein–positive at-risk individuals (CCP+ at-risk) compared with a healthy control group and patients with early rheumatoid arthritis (RA)? 

CCP+ "at risk" individuals were recruited from a single teaching hospital (2015 to 2017) and underwent periodontal assessments and examination of joints using ultrasonography.

Of the 48 CCP+ at-risk individuals (mean age 51.9 years) 46 had no joint inflammation on ultrasonography, but 35 (73%) had clinical periodontisis. Thus periodontitis in the CCP+ at risk groups was significantly greater than that seen in healthy individuals (38%), and ERA (54%).

The median percentage of periodontal sites was greater in CCP+ at-risk individuals compared with healthy individuals (3.3%). 

Patients with CCP+ at-risk had increased relative abundance of Porphyromonas gingivalis.

Given a substantial rate of progression to RA in asymptomatic, CCP+, no arthritis, "at risk" individuals (as high as 35%), the identification of periodontitis and P gingivalis in such individuals creates an opportunity preventive interventions of RA.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

A Multidimensional Definition of Remission

A study from Leeds suggests 'multi-dimensional remission' (MDR) can be seen in one-third of RA patients achieving DAS28-remission; such patients have better patient-reported outcome measures, making it an optimal goal, especially from a patient's perspective.

Good Pregnancy Outcomes for DMARD Exposed JIA Patients

A study of pregnancy outcomes in 98 women with juvenile idiopathic arthritis (JIA) who were exposed to DMARDs shows no increased risk of major adverse pregnancy outcomes.

A total of 152 pregnancies in 98 women with JIA and 39 pregnancies involving 21 male patients as partners were reviewed. The majority had a polyarticular JIA (61%). The average age at first pregnancy was 24.1 years, and their mean disease duration was 13.8 years.

Autoantibodies Don't Disappear With Remission in RA

Immunologic remission in rheumatoid arthritis, defined as the disappearance of anti-citrullinated protein antibodies and rheumatoid factor, was seen infrequently among patients achieving sustained clinical remission and did not correlate with the disappearance of symptoms, a long-term Dutch study found.

Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease

Serologic testing is the principal means of laboratory diagnosis of Lyme disease. Current recommendations include using a sensitive enzyme immunoassay (EIA) or immunofluorescence assay, followed by a western immunoblot assay for specimens yielding positive or equivocal results. On July 29, 2019, the Food and Drug Administration cleared several Lyme disease serologic assays with new indications for use, allowing for an EIA rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. Thus, serologic assays that utilize a second EIA in place of western immunoblot assay are acceptable alternatives for the serologic diagnosis of Lyme disease.

Trends in Inflammatory Arthritis Care in Germany

The German National Database (NDB) has reviewed their experience in the care and quality of life of inflammatory rheumatic disease patients snce 1993, showing improved use of metrics, improved outcomes and a changing profile of biologic and anti-rheumatic drug use.