Clinical Rheumatology

, Volume 33, Issue 4, pp 505–509 | Cite as

Periodontitis treatment improves systemic lupus erythematosus response to immunosuppressive therapy

  • Cristiana Fabbri
  • Ricardo Fuller
  • Eloisa Bonfá
  • Lissiane K. N. Guedes
  • Paulo Sergio R. D’Alleva
  • Eduardo F. Borba
Original Article

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.

Keywords

Inflammation Periodontitis Systemic lupus erythematosus Treatment 

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Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Cristiana Fabbri
    • 2
  • Ricardo Fuller
    • 1
    • 3
  • Eloisa Bonfá
    • 1
  • Lissiane K. N. Guedes
    • 1
  • Paulo Sergio R. D’Alleva
    • 2
  • Eduardo F. Borba
    • 1
  1. 1.Rheumatology Division of São Paulo UniversityFaculdade de Medicina da Universidade de São PauloSão PauloBrazil
  2. 2.Odontology Division of São Paulo UniversityFaculdade de Medicina da Universidade de São PauloSão PauloBrazil
  3. 3.Rheumatology Division of São Paulo UniversityFaculdade de Medicina da Universidade de São PauloSão PauloBrazil

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