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Joint Bone Spine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le dimanche 9 février 2020
Doi : 10.1016/j.jbspin.2019.12.003
accepted : 12 December 2019
Efficacy of baricitinib on periodontal inflammation in patients with rheumatoid arthritis
 

Codrina Ancuța a, b, Cristina Pomîrleanu a, b, Claudia Mihailov c, Rodica Chirieac d, Eugen Ancuța e, Cristina Iordache f, , Codruța Bran g, Oana Țănculescu h
a Rheumatology Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania 
b 2nd Rheumatology Department, Clinical Rehabilitation, 700661 Iași, Romania 
c Internal Medicine and Rheumatology Department, “Ovidius” University, 900470 Constanța, Romania 
d SANOCARE Medical and Research Center, 700531 Iasi, Romania 
e Research Department, “Elena Doamna” Clinical Hospital, 700398 Iasi, Romania 
f Implantology, Removable Dentures, Dental Technology Department, Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115, Romania 
g Rheumatology Department, “Sfantu Ioan” Clinical Emergency Hospital, 789007 Suceava, Romania 
h Odontology-Periodontology and Fixed Proshodontics Department, Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania 

Corresponding author. Implantology, Removable Dentures, Dental Technology Department, Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115, Romania.Implantology, Removable Dentures, Dental Technology Department, Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy700115Romania
Highlights

rheumatoid arthritis, particularly severe active ACPA-positive disease, is basically associated with altered periodontal health.
despite a widely recognized bidirectional relationship between rheumatoid arthritis and periodontal disease, the influence of innovative anti-rheumatic drugs in modulating periodontal microenvironment remains debatable.
oral Janus kinase inhibitors e.g. baricitinib may have a dual impact on articular and periodontal disease by targeting intracellular pathways and inhibiting multiple cytokines.

The full text of this article is available in PDF format.
Abstract
Objective

Despite a widely recognized bidirectional pathobiologic relationship between rheumatoid arthritis (RA) and periodontal disease, the impact of innovative anti-rheumatic drugs in modulating not only inflammatory and immune articular damage, but also periodontal microenvironment remains debatable. We aimed to evaluate the periodontal status in RA with and without baricitinib, a Janus kinase (JAK) inhibitor, and to better describe association between these entities.

Methods

We performed a prospective longitudinal 24-weeks study in 21 active RA initiating baricitinib. Standard assessments included a dual rheumatologic (RA activity, disability, serological, inflammatory profile) and dental evaluation comprising plaque index, gingival index, bleeding on probing, probing depth, clinical attachment level.

Results

More than half of RA presented at baseline with chronic periodontitis, as suggested by high prevalence of sites with dental plaque, abnormal bleeding on probing, probing depth and clinical attachment level. Aggressive periodontal disease was reported particularly in disease subsets with excessive inflammatory (serumC reactive protein level) and serologic biomarkers (anti-citrullinated peptide antibodies). Furthermore, significant correlations between dental pathology, disease activity and ACPA levels were also reported (P <0.05). Consistent improvement was noticed in both rheumatoid arthritis characteristics and periodontal status after 24 weeks of baricitinib (P <0.05).

Conclusion

RA, particularly severe active ACPA-positive disease, is basically associated with altered periodontal health. JAK blockade through oral baricitinib may be efficient in patients with active RA and potentially able to modulate the inflammatory process in the periodontal tissue.

The full text of this article is available in PDF format.

Keywords : Rheumatoid arthritis, Periodontal disease, Baricitinib




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