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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.

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

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