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Periodontitis treatment improves systemic lupus erythematosus response to immunosuppressive therapy

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Abstract

Periodontal disease (POD) may affect rheumatic diseases severity, but there are no data regarding the effect of its treatment on disease activity in SLE patients under immunosuppressive therapy. Forty-nine consecutive SLE patients (SLEDAI ≥ 2) with POD and under corticosteroid and cyclophosphamide pulse therapy (IVCYC) were selected. Periodontal assessment included bleeding gingival index (BGI), probing depth (PD), and probing attachment level (PAL). At entry, POD was defined as BGI > 1 and patients were assigned to groups according to the availability of odontological intervention in TREATED (n = 32) and NOT TREATED (n = 17). SLEDAI and POD parameters were determined at entry and after 3 months. Age, female gender, and race were alike among TREATED and NOT TREATED (p > 0.05). Both groups had also comparable disease duration (10.7 ± 6.8 vs. 11.0 ± 6.6, p = 0.83), IVCYC number (5.8 ± 4.8 vs. 4.5 ± 4.8, p = 0.17), and SLEDAI (5.9 ± 4.2 vs. 6.3 ± 4.3, p = 0.73) as well as POD parameters [BGI (40.8 ± 31.0 vs. 40.7 ± 36.2 %, p = 0.89), PD (1.7 ± 1.8 vs. 1.5 ± 0.60 mm, p = 0.80), and PAL (2.5 ± 1.9 vs. 1.9 ± 1.1 mm, p = 0.18)]. At the end of the study, TREATED group had a significant improvement in SLEDAI (5.9 ± 4.2 vs. 3.4 ± 3.3, p = 0.04) with a paralleled reduction in BGI (40.8 ± 31.0 vs. 15.2 ± 17.2 %, p < 0.01), PD (1.7 ± 1.8 vs. 1.1 ± 0.3 mm, p < 0.01), and PAL (2.5 ± 1.9 vs. 1.7 ± 0.9 mm, p < 0.01). In contrast, SLEDAI (6.3 ± 4.3 vs. 6.0 ± 5.5, p = 0.40) and POD parameters [BGI (p = 0.33), PD (p = 0.91), and PAL (p = 0.39)] remained largely unchanged in NOT TREATED group. Periodontal disease treatment seems to have a beneficial effect in controlling disease activity in SLE patients under immunosuppressive therapy. Therefore, management of this modifiable risk factor is recommended.

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Acknowledgements

This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ grants #301411/2009-3 to EB and #306963/2011-6 to EFB) and Federico Foundation Grant (to EFB and EB).

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Authors and Affiliations

  1. Rheumatology Division of São Paulo University, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Ricardo Fuller, Eloisa Bonfá, Lissiane K. N. Guedes & Eduardo F. Borba

  2. Odontology Division of São Paulo University, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Cristiana Fabbri & Paulo Sergio R. D’Alleva

  3. Rheumatology Division of São Paulo University, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo 455, 3º andar, Sala 3190, São Paulo, São Paulo, Brazil, 01246903

    Ricardo Fuller

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  1. Cristiana Fabbri
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Correspondence to Ricardo Fuller.

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Fabbri, C., Fuller, R., Bonfá, E. et al. Periodontitis treatment improves systemic lupus erythematosus response to immunosuppressive therapy. Clin Rheumatol 33, 505–509 (2014). https://doi.org/10.1007/s10067-013-2473-2

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