Relationship between Tooth Loss and the Medications Used for the Treatment of Rheumatoid Arthritis in Japanese Patients with Rheumatoid Arthritis: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Assessment of Clinical Rheumatological Parameters
2.3. Oral Examination
2.4. Questionnaires
2.5. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Farronato, M.; Cavagnetto, D.; Abate, A.; Cressoni, P.; Fama, A.; Maspero, C. Assessment of condylar volume and ramus height in JIA patients with unilateral and bilateral TMJ involvement: Retrospective case-control study. Clin. Oral Investig. 2019, 24, 2635–2643. [Google Scholar] [CrossRef]
- Maspero, C.; Cavagnetto, D.; Abate, A.; Cressoni, P.; Farronato, M. Effects on the Facial Growth of Rapid Palatal Expansion in Growing Patients Affected by Juvenile Idiopathic Arthritis with Monolateral Involvement of the Temporomandibular Joints: A Case-Control Study on Posteroanterior and Lateral Cephalograms. J. Clin. Med. 2020, 9, 1159. [Google Scholar] [CrossRef]
- Abate, A.; Cavagnetto, D.; Rusconi, F.M.E.; Cressoni, P.; Esposito, L. Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study. Children 2021, 8, 33. [Google Scholar] [CrossRef]
- Smolen, J.S.; Landewé, R.; Breedveld, F.C.; Buch, M.; Burmester, G.; Dougados, M. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann. Rheum. Dis. 2014, 73, 492–509. [Google Scholar] [CrossRef]
- Singh, J.A.; Furst, D.E.; Bharat, A.; Curtis, J.R.; Kavanaugh, A.F.; Kremer, J.M.; Moreland, L.W.; O’Dell, J.; Winthrop, K.L.; Beukelman, T.; et al. 2012 Update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Rheum. 2012, 64, 625–639. [Google Scholar] [CrossRef] [Green Version]
- Äyräväinen, L.; Leirisalo-Repo, M.; Kuuliala, A.; Ahola, K.; Koivuniemi, R.; Meurman, J.H.; Heikkinen, A.M. Periodontitis in early and chronic rheumatoid arthritis: A prospective follow-up study in Finnish population. BMJ Open 2017, 7, e011916. [Google Scholar] [CrossRef] [Green Version]
- Fuggle, N.R.; Smith, T.O.; Kaul, A.; Sofat, N. Hand to Mouth: A Systematic Review and Meta-Analysis of the Association between Rheumatoid Arthritis and Periodontitis. Front. Immunol. 2016, 7, 80. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mikuls, T.R.; Payne, J.B.; Yu, F.; Thiele, G.M.; Reynolds, R.J.; Cannon, G.W.; Markt, J.; McGowan, D.; Kerr, G.S.; Redman, R.S.; et al. Periodontitis and Porphyromonas gingivalis in patients with rheumatoid arthritis. Arthritis Rheumatol. 2014, 66, 1090–1100. [Google Scholar] [CrossRef] [Green Version]
- Page, R.C.; Offenbacher, S.; Schroeder, H.E.; Seymour, G.J.; Kornman, K.S. Advances in the pathogenesis of periodontitis: Summary of developments, clinical implications and future directions. Periodontol. 2000 1997, 14, 216–248. [Google Scholar] [CrossRef]
- Kobayashi, T.; Okada, M.; Ito, S.; Kobayashi, D.; Ishida, K.; Kojima, A.; Narita, I.; Murasawa, A.; Yoshie, H. Assessment of Interleukin-6 Receptor Inhibition Therapy on Periodontal Condition in Patients With Rheumatoid Arthritis and Chronic Periodontitis. J. Periodontol. 2014, 85, 57–67. [Google Scholar] [CrossRef]
- Kobayashi, T.; Yokoyama, T.; Ito, S.; Kobayashi, D.; Yamagata, A.; Okada, M.; Oofusa, K.; Narita, I.; Murasawa, A.; Nakazono, K.; et al. Periodontal and Serum Protein Profiles in Patients With Rheumatoid Arthritis Treated With Tumor Necrosis Factor Inhibitor Adalimumab. J. Periodontol. 2014, 85, 1480–1488. [Google Scholar] [CrossRef]
- Ziebolz, D.; Rupprecht, A.; Schmickler, J.; Bothmann, L.; Krämer, J.; Patschan, D.; Müller, G.A.; Mausberg, R.F.; Schmidt, J.; Schmalz, G.; et al. Association of different immunosuppressive medications with periodontal condition in patients with rheumatoid arthritis: Results from a cross-sectional study. J. Periodontol. 2018, 89, 1310–1317. [Google Scholar] [CrossRef]
- Arnett, F.C.; Edworthy, S.M.; Bloch, D.A.; McShane, D.J.; Fries, J.F.; Cooper, N.S.; Healey, L.A.; Kaplan, S.R.; Liang, M.H.; Luthra, H.S.; et al. The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988, 31, 315–324. [Google Scholar] [CrossRef]
- Steinbrocker, O.; Traeger, C.H.; Batterman, R.C. Therapeutic Criteria in Rheumatoid Arthritis. JAMA 1949, 140, 659–662. [Google Scholar] [CrossRef]
- Mobini, M.; Maboudi, A.; Mohammadpour, R.A. Periodontitis in rheumatoid arthritis patients, abundance and association with disease activity. Med. J. Islam. Repub. Iran 2017, 31, 252–256. [Google Scholar] [CrossRef] [Green Version]
- Schmickler, J.; Rupprecht, A.; Patschan, S.; Patschan, D.; Müller, G.A.; Haak, R.; Mausberg, R.F.; Schmalz, G.; Kottmann, T.; Ziebolz, D. Cross-Sectional Evaluation of Periodontal Status and Microbiologic and Rheumatoid Parameters in a Large Cohort of Patients With Rheumatoid Arthritis. J. Periodontol. 2017, 88, 368–379. [Google Scholar] [CrossRef]
- Aida, J.; Morita, M.; Akhter, R.; Aoyama, H.; Masui, M.; Ando, Y. Relationships between patient characteristics and reasons for tooth extraction in Japan. Community Dent Heal. 2009, 26, 104–109. [Google Scholar]
- Franks, A.S. Temporomandibular joint in adult rheumatoid arthritis. A comparative evaluation of 100 cases. Ann. Rheum. Dis. 1969, 28, 139–145. [Google Scholar] [CrossRef] [Green Version]
- Delantoni, A.; Spyropoulou, E.; Chatzigiannis, J.; Papademitriou, P. Sole radiographic expression of rheumatoid arthritis in the temporomandibular joints: A case report. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol. 2006, 102, e37–e40. [Google Scholar] [CrossRef]
- Gonzalez, S.M.; Payne, J.B.; Yu, F.; Thiele, G.M.; Erickson, A.R.; Johnson, P.G.; Schmid, M.J.; Cannon, G.W.; Kerr, G.S.; Reimold, A.M.; et al. Alveolar Bone Loss Is Associated With Circulating Anti-Citrullinated Protein Antibody (ACPA) in Patients With Rheumatoid Arthritis. J. Periodontol. 2015, 86, 222–231. [Google Scholar] [CrossRef] [PubMed]
- Lipsky, P.E.; Van Der Heijde, D.M.; Clair, E.W.S.; Furst, D.E.; Breedveld, F.C.; Kalden, J.R.; Smolen, J.S.; Weisman, M.; Emery, P.; Feldmann, M.; et al. Infliximab and Methotrexate in the Treatment of Rheumatoid Arthritis. N. Engl. J. Med. 2000, 343, 1594–1602. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bathon, J.M.; Martin, R.W.; Fleischmann, R.M.; Tesser, J.R.; Schiff, M.H.; Keystone, E.C.; Genovese, M.C.; Wasko, M.C.; Moreland, L.W.; Weaver, A.L.; et al. A Comparison of Etanercept and Methotrexate in Patients with Early Rheumatoid Arthritis. N. Engl. J. Med. 2000, 343, 1586–1593. [Google Scholar] [CrossRef]
- Genovese, M.C.; Bathon, J.M.; Martin, R.W.; Fleischmann, R.M.; Tesser, J.R.; Schiff, M.H.; Keystone, E.C.; Wasko, M.C.; Moreland, L.W.; Weaver, A.L.; et al. Etanercept versus methotrexate in patients with early rheumatoid arthritis: Two-year radiographic and clinical outcomes. Arthritis Rheum. 2002, 46, 1443–1450. [Google Scholar] [CrossRef]
- Brennan, D.S.; Spencer, A.J.; Roberts-Thomson, K.F. Tooth loss, chewing ability and quality of life. Qual. Life Res. 2007, 17, 227–235. [Google Scholar] [CrossRef] [PubMed]
- Su, F.H.; Wu, C.S.; Sung, F.C.; Chang, S.N.; Su, C.T.; Shieh, Y.H. Chronic hepatitis C virus infection is associated with the development of rheumatoid arthritis: A nationwide population-based study in Taiwan. PLoS ONE 2014, 9, 113579. [Google Scholar] [CrossRef]
- Naciute, M.; Mieliauskaite, D.; Rugiene, R.; Nikitenkiene, R.; Jancoriene, L.; Mauricas, M.; Nora-Krukle, Z.; Murovska, M.; Girkontaite, I. Frequency and significance of parvovirus B19 infection in patients with rheumatoid arthritis. J. Gen. Virol. 2016, 97, 3302–3312. [Google Scholar] [CrossRef]
- Scrimshaw, N.S. Effect of infection on nutrient requirements. Am. J. Clin. Nutr. 1977, 30, 1536–1544. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lee, D.M.; Weinblatt, M.E. Rheumatoid arthritis. Lancet 2001, 358, 903–911. [Google Scholar] [CrossRef]
- Uhlig, T.; Kvien, T.K.; Jensen, J.L.; Axéll, T. Sicca symptoms, saliva and tear production, and disease variables in 636 patients with rheumatoid arthritis. Ann. Rheum. Dis. 1999, 58, 415–422. [Google Scholar] [CrossRef]
- Shimazaki, Y.; Fu, B.; Yonemoto, K.; Akifusa, S.; Shibata, Y.; Takeshita, T.; Ninomiya, T.; Kiyohara, Y.; Yamashita, Y. Stimulated salivary flow rate and oral health status. J. Oral Sci. 2017, 59, 55–62. [Google Scholar] [CrossRef] [Green Version]
Characteristics | Median (25th Percentile, 75th Percentile) or n (%) |
---|---|
Age | 62.0 (53.8, 73.3) |
BMI (kg/m2) | 21.3 (19.3, 23.2) |
Mean PPD (mm) | 2.85 (2.52, 3.34) |
Sex | |
Male | 27 (28.7) |
Female | 67 (71.3) |
Smoking status | |
Never | 53 (56.4) |
Former | 20 (21.3) |
Current | 21 (22.3) |
Number of teeth | |
27–28 | 34 (36.2) |
20–26 | 32 (34.0) |
≤19 | 28 (29.8) |
RA severity (class) | |
Ⅰ | 65 (69.1) |
Ⅱ | 17 (18.1) |
III–IV | 12 (12.8) |
RA severity (stage) | |
Ⅰ | 56 (59.6) |
Ⅱ | 19 (20.2) |
III–IV | 19 (20.2) |
RA medication | |
NSAIDs/Corticosteroids/DMARDs | 32 (34.0) |
MTX | 39 (41.5) |
bDMARDs | 23 (24.5) |
Number of Teeth | ||||
---|---|---|---|---|
27–28 | 20–26 | ≤19 | ||
n = 34 | n = 32 | n = 28 | p-Value | |
Age | 51.5 (44.0, 61.3) | 62.5 (57.0, 71.0) | 73.0 (65.3, 81.8) | <0.001 |
BMI (kg/m2) | 20.3 (18.8, 22.3) | 22.4 (19.7, 24.5) | 21.3 (19.4, 23.3) | 0.07 |
Mean PPD (mm) | 2.57 (2.48, 2.77) | 2.79 (2.49, 3.27) | 3.41 (2.92, 4.24) | <0.001 |
Sex | ||||
Male | 9 (26.5) | 10 (31.3) | 8 (28.6) | 0.91 |
Female | 25 (73.5) | 22 (68.8) | 20 (71.4) | |
Smoking status | ||||
Never | 21 (61.8) | 16 (50.0) | 16 (57.1) | 0.05 |
Former | 2 (5.9) | 11 (34.4) | 7 (25.0) | |
Current | 11 (32.4) | 5 (15.6) | 5 (17.9) | |
RA severity (class) | ||||
Ⅰ | 29 (85.3) | 21 (65.6) | 15 (53.6) | 0.009 |
II | 3 (8.8) | 9 (28.1) | 5 (17.9) | |
III or IV | 2 (5.9) | 2 (6.3) | 8 (28.6) | |
RA severity (stage) | ||||
Ⅰ | 20 (58.8) | 20 (62.5) | 16 (57.1) | 0.94 |
II | 8 (23.5) | 5 (15.6) | 6 (21.4) | |
III or IV | 6 (17.6) | 7 (21.9) | 6 (21.4) | |
RA medication | ||||
NSAIDs/ Corticosteroids/ DMARDs | 17 (50.0) | 11 (34.4) | 4 (14.3) | 0.01 |
MTX | 11 (32.4) | 16 (50.0) | 12 (42.9) | |
bDMARDs | 6 (17.6) | 5 (15.6) | 12 (42.9) |
RA Medication | ||||
---|---|---|---|---|
NSAIDs/ Corticosteroids/ DMARDs | MTX | bDMARDs | ||
n = 32 | n = 39 | n = 23 | p-Value | |
Age | 60.5 (52.3, 66.7) | 62.0 (54.0, 73.0) | 68.0 (57.0, 83.0) | 0.07 |
BMI (kg/m2) | 20.8 (18.8, 23.7) | 21.6 (19.4, 23.5) | 21.4 (19.6, 22.9) | 0.74 |
Mean PPD (mm) | 2.68 (2.47, 3.15) | 2.94 (2.64, 3.64) | 2.85 (2.52, 3.44) | 0.17 |
Number of teeth | ||||
27–28 | 17 (53.1) | 11 (28.2) | 6 (26.1) | 0.01 |
20–26 | 11 (34.4) | 16 (41.0) | 5 (21.7) | |
≤19 | 4 (12.5) | 12 (30.8) | 12 (52.2) | |
Sex | ||||
Male | 12 (37.5) | 13 (33.3) | 2 (8.7) | 0.05 |
Female | 20 (29.9) | 26 (66.7) | 21 (91.3) | |
Smoking status | ||||
Never | 16 (50.0) | 20 (51.3) | 17 (73.9) | 0.35 |
Former | 7 (21.9) | 9 (23.1) | 4 (17.4) | |
Current | 9 (28.1) | 10 (25.6) | 2 (8.7) | |
RA severity (class) | ||||
I | 28 (87.5) | 29 (74.4) | 8 (34.8) | <0.001 |
II | 3 (9.4) | 7 (17.9) | 7 (30.4) | |
III or IV | 1 (3.1) | 3 (7.7) | 8 (34.8) | |
RA severity (stage) | ||||
I | 26 (81.3) | 25 (64.1) | 5 (21.7) | <0.001 |
II | 4 (12.5) | 9 (23.1) | 6 (26.1) | |
III or IV | 2 (6.3) | 5 (12.8) | 12 (52.2) |
Model 1 | Model 2 | |||
---|---|---|---|---|
Dependent Variable: RA Medication | Dependent Variable: RA Medication | |||
MTX vs. NSAIDs/Corticosteroids/ DMARDs | bDMARDs vs. NSAIDs/Corticosteroids/ DMARDs | MTX vs. NSAIDs/Corticosteroids/ DMARDs | bDMARDs vs. NSAIDs/Corticosteroids/ DMARDs | |
Independent variable | Adjusted OR (95% CI) | Adjusted OR (95% CI) | Adjusted OR (95% CI) | Adjusted OR (95% CI) |
Age | 0.96 (0.91, 1.01) | 0.95 (0.89, 1.02) | 0.96 (0.92, 1.01) | 0.99 (0.93, 1.05) |
BMI (kg/m2) | 1.10 (0.93, 1.30) | 1.19 (0.96, 1.47) | 1.06 (0.89, 1.26) | 1.10 (0.88, 1.37) |
Mean PPD (mm) | 1.05 (0.34, 3.28) | 0.47 (0.10, 2.28) | 1.22 (0.39, 3.75) | 0.35 (0.07, 1.78) |
Number of teeth | ||||
27–28 | 1 | 1 | 1 | 1 |
20–26 | 2.95 (0.72, 12.1) | 0.97 (0.14, 6.85) | 3.66 (0.88, 15.1) | 1.55 (0.20, 12.2) |
≤19 | 8.74 (1.11, 68.8) * | 21.0 (1.30, 339.1) * | 9.71 (1.22, 77.1) * | 50.2 (2.55, 990.6) * |
Sex | ||||
Male | 1 | 1 | 1 | 1 |
Female | 1.31 (0.37, 4.68) | 5.56 (0.69, 45.2) | 1.28 (0.36, 4.54) | 5.41 (0.68, 43.2) |
Smoking status | ||||
Never | 1 | 1 | 1 | 1 |
Former | 0.82 (0.18, 3.68) | 0.97 (0.13, 7.44) | 0.69 (0.15, 3.14) | 1.14 (0.14, 9.03) |
Current | 0.84 (0.21, 3.40) | 0.89 (0.10, 7.59) | 0.69 (0.16, 2.86) | 0.96 (0.09, 9.84) |
RA severity (class) | ||||
I | 1 | 1 | ||
II | 2.54 (0.51, 12.7) | 15.6 (2.19, 111.1) ** | ||
III or IV | 4.47 (0.27, 73.7) | 62.4 (2.95, 1320.9) ** | ||
RA severity (stage) | ||||
I | 1 | 1 | ||
II | 3.44 (0.84, 14.1) | 8.32 (1.20, 57.5) * | ||
III or IV | 2.23 (0.33, 15.2) | 59.7 (6.86, 519.1) ** |
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Hashimoto, H.; Hashimoto, S.; Shimazaki, Y. Relationship between Tooth Loss and the Medications Used for the Treatment of Rheumatoid Arthritis in Japanese Patients with Rheumatoid Arthritis: A Cross-Sectional Study. J. Clin. Med. 2021, 10, 876. https://doi.org/10.3390/jcm10040876
Hashimoto H, Hashimoto S, Shimazaki Y. Relationship between Tooth Loss and the Medications Used for the Treatment of Rheumatoid Arthritis in Japanese Patients with Rheumatoid Arthritis: A Cross-Sectional Study. Journal of Clinical Medicine. 2021; 10(4):876. https://doi.org/10.3390/jcm10040876
Chicago/Turabian StyleHashimoto, Hiroko, Shimpei Hashimoto, and Yoshihiro Shimazaki. 2021. "Relationship between Tooth Loss and the Medications Used for the Treatment of Rheumatoid Arthritis in Japanese Patients with Rheumatoid Arthritis: A Cross-Sectional Study" Journal of Clinical Medicine 10, no. 4: 876. https://doi.org/10.3390/jcm10040876