Evidence-Based Research on Effectiveness of Periodontal Treatment in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis.


Journal

Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086

Informations de publication

Date de publication:
10 2022
Historique:
revised: 22 02 2021
received: 28 09 2020
accepted: 13 04 2021
pubmed: 12 5 2021
medline: 1 10 2022
entrez: 11 5 2021
Statut: ppublish

Résumé

To gauge the evidence of periodontal therapy's impact on measures of disease activity and systemic inflammatory burden in individuals with rheumatoid arthritis (RA). A search for randomized trials and controlled cohort studies of RA patients with periodontitis was conducted on April 7, 2019, with an update on December 17, 2020 in PubMed, Cochrane Library (CENTRAL), Embase, ClinicalTrials.gov, and the World Health Organization International Clinical Trial Registry Platform portal. Two reviewers screened titles and abstracts and selected papers for full-text review. We used Outcome Measures in Rheumatology (OMERACT)-endorsed outcome domains for RA trials and summarized continuous outcomes using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs). We evaluated inconsistency using the I Of the 1,909 studies identified, 9 (including 10 comparisons) were eligible for quantitative synthesis (n = 388). Evidence suggested a favorable effect of periodontal treatment on disease activity (SMD -0.88 [95% CI -1.38, -0.38]; n = 311). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to judge the estimates' certainty; evidence rated as having low or very low certainty indicated that any possible effect of periodontal treatment in RA is likely to change as more evidence is provided. Selection bias and RA medication stability were highlighted as sources of heterogeneity between studies. There is an urgent need for a well-designed prospective cohort study (preferably a randomized controlled trial) of patients with RA and periodontitis using rigorous protocols, standardized diagnostic criteria, data collection, and adequate duration of follow-up.

Identifiants

pubmed: 33973383
doi: 10.1002/acr.24622
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1723-1735

Informations de copyright

© 2021 American College of Rheumatology.

Références

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Auteurs

Daniela S Silva (DS)

University of Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, and the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.

Flávio Costa (F)

Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Isabel P Baptista (IP)

University of Coimbra, Coimbra, Portugal.

Tânia Santiago (T)

Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Hans Lund (H)

Western Norway University of Applied Sciences, Bergen, Norway.

Simon Tarp (S)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.

José A P daSilva (JAP)

Centro Hospitalar e Universitário de Coimbra and University of Coimbra, Coimbra, Portugal.

Robin Christensen (R)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark, and University of Southern Denmark, Odense University Hospital, Odense, Denmark.

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