Session Title: Imaging of Rheumatic Diseases Poster III: Other Modalities
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Rheumatoid arthritis(RA) and periodontitis have been suggested to be related, and they share many clinical and pathologic features. Both diseases are chronic inflammatory diseases characterized by the accumulation and persistence of inflammatory infiltrates in local lesions. Patients with RA are more likely to have periodontitis, and some reports said the treatment response to RA was less in patients with periodontitis than those without periodontitis. However, there has been no report investigating the relationship between the degree of periodontitis and the treatment response to RA. And it is said that [18F] fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) can evaluate both the degree of synovitis of RA and periodontitis.
The aim of this study was to evaluate the relationship between periodontitis and the treatment response to biologics in RA using FDG-PET/CT.
Sixty RA patients (14 males, 46 females, average age 58.3(17-80) years) treated with biological therapies were assessed. FDG-PET was performed at baseline and six months after the initiation of biological therapy. The maximum standardized uptake value (SUVmax) was used as a representative value for the assessment of the FDG uptake in periodontal tissue (upper posterior gingival tissue). We also evaluated the DAS28-CRP and several clinical parameters (CRP, ESR, anti-cyclic citrullinated peptide antibody [ACPA], rheumatoid factor [RF], matrix metalloproteinase 3 [MMP-3] ). Wilcoxon’s signed rank sum test and Spearman’s rank correlation test were used to assess the correlation between the periodontal SUVmax and the clinical parameters.
Periodontal SUVmax at baseline had relation with patient age (r=0.302, p=0.009) and ACPA value (r=0.265, p=0.025).
After biological therapies, the values for DAS28-CRP, CRP, ESR, and MMP-3 were significantly decreased after 6 months. However, the mean periodontal SUVmax increased from 1.83 to 1.88, indicating no significant change in the periodontal SUVmax after treatment. The ACPA and RF values also did not change markedly after treatment. In contrast, we noted a significantly negative correlation between the baseline periodontal SUVmax and the ΔDAS28-CRP (r=-0.369, p=0.004).
The baseline periodontal SUVmax had a positive correlation with ACPA value. Biological therapies for RA might not cure periodontitis. In addition, concurrent periodontitis might reduce the response to biological therapies in RA patients.
To cite this abstract in AMA style:Tachibana M, Yonemoto Y, SUTO T, OKAMURA K, OKURA C, SAKANE H, CHIKUDA H. The Relationship between Periodontitis and the Treatment Response to Biologics in Rheumatoid Arthritis Patients; A Post-Hoc Analysis Using [18F] Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/the-relationship-between-periodontitis-and-the-treatment-response-to-biologics-in-rheumatoid-arthritis-patients-a-post-hoc-analysis-using-18f-fluorodeoxyglucose-positron-emission-tomography-compute/. Accessed July 7, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-relationship-between-periodontitis-and-the-treatment-response-to-biologics-in-rheumatoid-arthritis-patients-a-post-hoc-analysis-using-18f-fluorodeoxyglucose-positron-emission-tomography-compute/