SAT0160 Effect of periodontal treatment on e-selectin level in rheumatoid arthritis patients

Abstract

Background: Cardiovascular (CV) disease is the main cause of mortality in rheumatoid arthritis (RA).1 Studies showed that periodontitis is associated with RA and CV diseases.2-4 Endothelial dysfunction is the first step in the pathogenesis of atherosclerosis. E-selectin is a marker of endothelial dysfunction and was expressed specifically in endothelial cells. To date, there is no study on the effect of periodontal treatment on endothelial dysfunction in RA patients. Objectives: To determine the effect of periodontal treatment on E-selectin level in RA patients. Methods: This was a clinical trial in RA patients visiting Rheumatology Clinic in our hospital between March-May 2017. Inclusion criteria: adult RA patients, has periodontitis, low-high RA disease activity, RA duration of 10 years or less, has received DMARD. Exclusion criteria: subjects who smoke, have diabetes, underwent dental treatment for the past 3 months, have other autoimmune diseases, and patients who refused to join the study. Subjects was randomized into intervention group (periodontal scaling for 1 month) and control group. Study flow is visualized in figure 1. E-selectin level was measured at the start and at the end of the study. T-test was used to measure the difference of E-selectin level changes before-after study between groups. Results: There were 31 subjects who completed the study. The prevalence of periodontitis was 64.5%. There was no statistically significant difference on delta E-selectin before-after treatment between both groups (table 1). We further divided the subjects based on disease activity and lipid profile at the end of the study. Subjects on the treatment group who was on remission and has normal lipid profile (normal LDL and decreased total cholesterol/HDL ratio) has decreased Eselectin level compared to other subjects (Table Presented) Conclusions: Periodontal treatment for a month has no effect on E-selectin level in RA patients. Further studies on the effect of periodontal treatment on endothelial dysfunction in RA patient needs to be done on patients on remission, without dyslipidemia, and with longer treatment period.