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Abstract Number: 1698

The Association between Periodontitis and the Disease Activity of Systemic Lupus Erythematosus: A Cross-Sectional Study

Nobuyuki Yajima1,2,3, Tsukasa Kamitani3, Mayu Saito1, Shingo Fukuma4, Yoko Koide5, Yoshimasa Okamatsu6, Kazuyuki Araki7, Yukiko Matsuda8 and Shunichi Fukuhara3, 1Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan, 2Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan, 3Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan, 4Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan, 5Department of Periodontology, Showa University School of Dentistry, Tokyo, Japan, 6Department of Special Needs Dentistry, Division of Community Based Comprehensive Dentistry, Showa University School of Dentistry, Tokyo, Japan, 7Division of Radiology, Department of Oral Diagnostic Sciences,, Showa University School of Dentistry, Tokyo, Japan, 8Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, Tokyo, Japan

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Periodontitis and systemic lupus erythematosus (SLE)

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Session Information

Date: Monday, October 22, 2018

Session Title: Systemic Lupus Erythematosus – Clinical Poster II: Biomarkers and Outcomes

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Periodontitis is common disease. Recently, it is pointed out that periodontitis was associated with systemic disease. There were a few studies of assessing the relationship between periodontitis and the disease activity of systemic lupus erythematosus(SLE). However, it was unclear that there was evidence to support the relationship. Our hypothesis is that periodontitis is associated with the disease activity of SLE. This study aimed to assess the association between periodontitis and the disease activity of SLE.

Methods:

Design: A cross-sectional study.

Participants: SLE patients (according to the criteria revised in 1997 by the American College of Rheumatology) who diagnosed at Showa University Hospital, who were under 65-years-old and were collected from June 2016 to December 2016.

Exposure: Our main exposure was periodontitis assessed with pocket of depth, attachment loss by dentists. We divided a grade of periodontitis into four categories (Non-periodontitis, Mild periodontitis, Moderate periodontitis, Severe periodontitis) by Centers for Disease Control and Prevention – The American Academy of Periodontology (CDC-APP) definition.

Outcome measures:

Main outcome was Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2000). Secondary outcome were anti-dsDNA antibody level, and complement level.

Statistical Analysis: In the main analysis, a multiple regression analysis using the score of SLEDAI-2000 as outcome was conducted to assess the association between periodontitis and the disease activity of SLE with adjustment for age, sex, current smoking status, current prednisolone(PSL) dose, the maximum dose of past PSL treatment and current immunosuppressant therapy. In the secondary analysis, a multiple regression analysis was conducted to analyze the association between periodontitis and the anti-dsDNA antibody level, complement level under the same conditions as above. In multivariable analysis, missing variables were replaced by multiple imputation.

Results: Among 119 SLE patients, mean age was 40.0 years, and 88.2% was female. The prevalence of periodontitis was 69% (1.7% in mild periodontitis, 58.8% in moderate periodontitis, 8.4% in severe periodontitis). Compared with non-periodontitis, the regression coefficients [95% Confident Interval] for SLEDAI of mild periodontitis, moderate periodontitis and severe periodontitis were -4.74 [-11.23 to 1.76], -1.07 [-2.99 to 0.83] and 0.54 [-4.08 to 3.01], respectively. In the secondary analysis, compared with non-periodontitis, the regression coefficients [95%CI] for SLEDAI of severe periodontitis for anti-dsDNA antibody titer was statistically significant (44.6 [7.3-81.9]).

Conclusion: This study demonstrated for the first time in Japan that the prevalence of periodontitis in SLE patients was remarkably high. Our data raise the important possibility that physicians pay attention to periodontitis in SLE practice. Our result did not provide a clear association between periodontitis and the disease activity of SLE. Further studies are needed to test our hypothesis in a longitudinal study in the future.


Disclosure: N. Yajima, None; T. Kamitani, None; M. Saito, None; S. Fukuma, None; Y. Koide, None; Y. Okamatsu, None; K. Araki, None; Y. Matsuda, None; S. Fukuhara, None.

To cite this abstract in AMA style:

Yajima N, Kamitani T, Saito M, Fukuma S, Koide Y, Okamatsu Y, Araki K, Matsuda Y, Fukuhara S. The Association between Periodontitis and the Disease Activity of Systemic Lupus Erythematosus: A Cross-Sectional Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/the-association-between-periodontitis-and-the-disease-activity-of-systemic-lupus-erythematosus-a-cross-sectional-study/. Accessed March 21, 2023.
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