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临床试验/NCT05502601
NCT05502601尚未招募不适用

Impact of Non-surgical Periodontal Therapy in the Systemic and Clinical Conditions of Patients With Rheumatoid Arthritis: a 6-months Randomized Controlled Trial

Federal University of Rio Grande do Sul1 个研究点 分布在 1 个国家目标入组 42 人开始时间: 2022年12月15日最近更新:
适应症

试验速览

阶段
不适用
状态
尚未招募
发起方
入组人数
42
试验地点
1
主要终点
Changes in the Simplified disease activity index (SDAI)

研究概览

简要总结

Aim: A prospective randomized, controlled clinical trial comparing two groups of a cohort of Rheumatoid Arthritis (RA) patients with periodontal disease will be carried out to identify if the effect of non-surgical periodontal therapy is a predictor of remission/ low disease activity (LDA)-remission.

Methods: 42 patients with RA and periodontitis from the RA Almenara cohort will be included (ACR 1987 and or ACR/EULAR 2010 criteria with more than 16 years old at diagnosis); those with <6 teeth, current infections, cancer or oral precancerous lesions, diabetics, Sjogren's syndrome, use of antibiotics or drugs associated with dry mouth and dental surgery, will be excluded. Periodontal Disease was defined by the presence of periodontitis stage 3 or 4 with at least 2 non-adjacent teeth with insertion loss >=5mm, probing depth >=5mm and bleeding on probing according with the 2018 periodontitis diagnostic criteria.

Two RA patients groups will be follow up by monthly visits. Patients will be divided into two groups (intervention and no intervention treatment). PD treatment will be performed by a qualified periodontist. No intervention group will receive PD treatment after 6 month visit because ethical principles. Disease activity will be determined according with DAS 28index, Clinical Disease Activity Index (CDAI) and Simple Disease Activity Index (SDAI) scores, C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and rheumatoid factor levels will be registered before and after PD treatment (baseline, 3 and 6 months visits), and the differences between the groups will be analyzed and compared. Periodontal parameters including probing depth (PD), clinical attachment loss, and sulcus bleeding index (SBI) will be correlated with the factor levels.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
Single (Investigator)

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Patients of both sexes
  • Age ≥16 years at the time of diagnosis and who do not meet criteria of overlap with any other autoimmune disease.
  • Presence of six or more permanent teeth in the mouth, excluding third molars.
  • Presence of periodontitis stage 3 or 4 with at least 2 non-adjacent teeth with insertion loss >=5mm, probing depth >=5mm and bleeding on probing according to Tonetti et al.[35].
  • Willingness to attend all visits for the duration of the study.

排除标准

  • Patients with Sjogren's syndrome
  • - Severe ongoing systemic infection.
  • - Associated dental infection
  • - History of oral cavity cancer or precancerous lesion.
  • - Use of local or systemic antibiotics in the last 3 months (including tetracyclines or other medication that could change the periodontal evaluation in the investigator's opinion, such as heparin alendronate, antivitamin K).
  • - Medications that induce gingival hyperplasia (such as phenytoin, warfarin or cyclosporine).
  • - Pregnant or breastfeeding women
  • - Participation in another intervention study.
  • Patients with a history of PD treatment in the last 6 months or previous dental surgery)

结局指标

主要结局

Changes in the Simplified disease activity index (SDAI)

时间窗: Baseline, 3 and 6 months after treatment

The SDAI includes a 28-swollen joint count (28SJC), 28-tender joint count (28TJC), patient global assessment of disease activity (PtGA) on a 10-cm visual analog scale (VAS), provider global assessment of disease activity (PrGA) on a 10-cm VAS, and C-reactive protein (CRP) level in mg/dl. The unabbreviated scale title: Simplified disease SDAI is calculated as follows: SDAI = SJC + TJC +PtGA + EGA (Evaluator Global disease Activity) + CRP. activity index The SDAI has range from 0 to 86. higher scores mean a worse outcome.

Changes in the Disease Activity Score with 28-joint counts (DAS 28)

时间窗: Baseline, 3 and 6 months after treatment

The DAS28 includes a 28-swollen joint count (28SJC), 28-tender joint count (28TJC), ESR, and a patient global assessment of disease activity (PtGA) or GH (General Health) assessment on a VAS. It may also be calculated using C-reactive protein (CRP) level instead of Westergren ESR the unabbreviated scale title: Disease Activity Score (28-joint counts) A score greater than 5.1 indicates active disease and less than 3.2 indicates well-controlled disease. A score of less of than 2.6 indicates remission

Changes in the Clinical disease activity index (CDAI)

时间窗: Baseline, 3 and 6 months after treatment

The CDAI includes a 28-swollen joint count (28SJC), 28-tender joint count (28TJC), patient global assessment of disease activity (PtGA) on a 10-cm visual analog scale (VAS), and provider global assessment of disease activity (PrGA) on a 10-cm VAS The unabbreviated scale title: Clinical disease activity index The CDAI has range from 0 to 76. higher scores mean a worse outcome.

Changes in Antibodies to cyclic citrullinated protein (anti-CCP)

时间窗: Baseline, 3 and 6 months after treatment

measurement of CCP (cyclic citrullinated peptide) antibodies in the blood

Changes in rheumatoid factor (RF)

时间窗: Baseline, 3 and 6 months after treatment

measurement of the amount of the RF antibody in the blood

Changes in erythrocyte sedimentation rate (ESR)

时间窗: Baseline, 3 and 6 months after treatment

measurement of the erythrocyte sedimentation rate in a test tube

C-reactive protein (CRP)

时间窗: Baseline, 3 and 6 months after treatment

measurement of the level of c-reactive protein (CRP) in your blood.

次要结局

  • Changes in Probing pocket depth (PPD)(Baseline, 3 and 6 months after treatment)
  • Changes in Bleeding on probing (BOP)(Baseline, 3 and 6 months after treatment)
  • Changes in Plaque index (PI)(Baseline, 3 and 6 months after treatment)
  • Changes in Clinical attachment level (CAL)(Baseline, 3 and 6 months after treatment)

研究者

发起方
Federal University of Rio Grande do Sul
申办方类型
Other
责任方
Principal Investigator
主要研究者

Alex Nogueira Haas

Associate Professor

Federal University of Rio Grande do Sul

研究点 (1)

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