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Evidence-Based Research on Effectiveness of Periodontal Treatment in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis.
Silva, Daniela S; Costa, Flávio; Baptista, Isabel P; Santiago, Tânia; Lund, Hans; Tarp, Simon; daSilva, José A P; Christensen, Robin.
Afiliação
  • Silva DS; University of Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, and the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
  • Costa F; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
  • Baptista IP; University of Coimbra, Coimbra, Portugal.
  • Santiago T; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
  • Lund H; Western Norway University of Applied Sciences, Bergen, Norway.
  • Tarp S; The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
  • daSilva JAP; Centro Hospitalar e Universitário de Coimbra and University of Coimbra, Coimbra, Portugal.
  • Christensen R; The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark, and University of Southern Denmark, Odense University Hospital, Odense, Denmark.
Arthritis Care Res (Hoboken) ; 74(10): 1723-1735, 2022 10.
Article em En | MEDLINE | ID: mdl-33973383
OBJECTIVE: To gauge the evidence of periodontal therapy's impact on measures of disease activity and systemic inflammatory burden in individuals with rheumatoid arthritis (RA). METHODS: 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 I2 statistic and combined SMDs using random-effects models for the meta-analyses; fixed-effect meta-analyses were used for sensitivity analysis. To explore heterogeneity, we added stratified/meta-regression analyses, expressed in T2 . RESULTS: 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. CONCLUSION: 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.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artrite Reumatoide Tipo de estudo: Clinical_trials / Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artrite Reumatoide Tipo de estudo: Clinical_trials / Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article