Are There Any Common Genetic Risk Markers for Rheumatoid Arthritis and Periodontal Diseases? A Case-Control Study

Background. Several studies suggest that there is a biologically plausible connection between rheumatoid arthritis (RA) and periodontal diseases (PD). Both disorders are characterized as multifactorial diseases potentially sharing common risk factors. Based on the inflammatory nature of RA and PD, the impact of genetic variations of genes of the immune system on both diseases was studied in this study.Materials and Methods. We conducted a case-control study (n=201) comparing 101 RA patients suffering from periodontal disease of different severities (no/mild PD vs. severe PD) with 100 systemically healthy controls without RA and severe PD. The genotype, allele, and haplotype distributions of 22 SNPs of 13 pro- and anti-inflammatory cytokines were assessed applying sequence-specific PCR.Results. Evaluating the impact of cytokine SNPs in RA, we identified the G allele of rs1801275 in IL4Rα(p=0.043) and the G allele of rs361525 in TNFα(p=0.005) as disease-associated risk factors in bivariate analyses. In multivariate analyses, these significant associations could not be proven. The A allele of rs2430561 in IFNγwas indicative for severe periodontitis among the patients with rheumatoid arthritis (p=0.039). Investigating the impact of rs2430561 in IFNγon comorbidity using binary logistic regression analyses, the A allele was confirmed as an independent risk factor for severe periodontal disease and RA (p=0.024).Conclusions. These results emphasize the association of genetic variations in proinflammatory cytokines (TNFαand IFNγ) and cytokine receptor (IL4Rα) and RA and periodontal diseases. In multivariate analyses, the A allele of IFNγwas proven to be a significant marker of RA and PD comorbidities. The study broadens the knowledge about disease-specific differences in genetic composition and provides an improved understanding of a possible association of both diseases.

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Serious adverse events and the risk of stroke in patients with rheumatoid arthritis: results from the German RABBIT cohort

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-211209 ◽

2017 ◽

Vol 76 (9) ◽

pp. 1583-1590 ◽

Cited By ~ 11

Author(s):

Y Meissner ◽

A Richter ◽

B Manger ◽

HP Tony ◽

E Wilden ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Adverse Events ◽

Case Control Study ◽

Case Control ◽

Serious Adverse Events ◽

Increased Risk ◽

Serious Infections ◽

The Impact ◽

Control Study

ObjectiveIn the general population, the incidence of stroke is increased following other serious events and hospitalisation. We investigated the impact of serious adverse events on the risk of stroke in patients with rheumatoid arthritis (RA), taking risk factors and treatment into account.MethodsUsing data of the German biologics register RABBIT (Rheumatoid Arthritis: Observation of Biologic Therapy) with 12354 patients with RA, incidence rates (IRs) and risk factors for stroke were investigated using multi-state and Cox proportional hazard models. In addition, in a nested case–control study, all patients with stroke were matched 1:2 to patients with identical baseline risk profile and analysed using a shared frailty model.ResultsDuring follow-up, 166 strokes were reported. The overall IR was 3.2/1000 patient-years (PY) (95% CI 2.7 to 3.7). It was higher after a serious adverse event (IR: 9.0 (7.3 to 11.0)), particularly within 30 days after the event (IR: 94.9 (72.6 to 121.9)). The adjusted Cox model showed increased risks of age per 5 years (HR: 1.4 (1.3 to 1.5)), hyperlipoproteinaemia (HR: 1.6 (1.0 to 2.5)) and smoking (HR: 1.9 (1.3 to 2.6)). The risk decreased with better physical function (HR: 0.9 (0.8 to 0.96)). In the case–control study, 163 patients were matched to 326 controls. Major risk factors for stroke were untreated cardiovascular disease (HR: 3.3 (1.5 to 7.2)) and serious infections (HR:4.4 (1.6 to 12.5)) or other serious adverse events (HR: 2.6 (1.4 to 4.8)).ConclusionsIncident adverse events, in particular serious infections, and insufficient treatment of cardiovascular diseases are independent drivers of the risk of stroke. Physicians should be aware that patients who experience a serious event are at increased risk of subsequent stroke.

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SAT0077 CARDIOVASCULAR RISK ASSESSMENT WITH CAROTID ULTRASONOGRAPHY IN ADDITION TO THE TRADITIONAL CARDIOVASCULAR RISK FACTORS IN RHEUMATOID ARTHRITIS PATIENTS: A CASE CONTROL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6420 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 973-973

Author(s):

R. Gonzalez Mazario ◽

J. J. Fragio-Gil ◽

P. Martinez Calabuig ◽

E. Grau García ◽

M. De la Rubia Navarro ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Risk Factor ◽

Cardiovascular Risk ◽

Disease Duration ◽

Case Control Study ◽

Case Control ◽

Healthy Controls ◽

Carotid Ultrasonography ◽

Control Study

Background:Cardiovascular disease (CV) is the most frequent cause of death in rheumatoid arthritis (RA) patients. It is well known that RA acts as an independent cardiovascular risk factor.Objectives:To assess the CV risk in RA patients using carotid ultrasonography (US) additionally to the traditional CV risk factors.Methods:A prospective transversal case control study was performed, including adult RA patients who fulfilled ACR/EULAR 2010 criteria and healthy controls matched according to CV risk factors. Population over 75 years old, patients with established CV disease and/or chronic kidney failure (from III stage) were excluded. The US evaluator was blinded to the case/control condition and evaluated the presence of plaques and the intima-media thickness. Statistical analysis was performed with R (3.6.1 version) and included a multivariate variance analysis (MANOVA) and a negative binomial regression adjusted by confounding factors (age, sex and CV risk factors).Results:A total of 200 cases and 111 healthy controls were included in the study. Demographical, clinical and US data are exposed in table 1. Not any difference was detected in terms of CV risk factors between the cases and controls. In both groups a relationship between age, BMI and high blood pressure was detected (p<0.001).Table 1.Table 2.RA basal characteristicsDisease duration (years)16,98 (11,38)Erosions (X-Ray of hands/feet)163 (81,5%)Seropositive (RF/anti-CCP)146 (73%)Extra-articular symptoms44 (22%)Intersticial difusse lung disease10 (5%)Rheumatoid nodules14 (7%)Prednisone use103 (51,5%)Median dose of Prednisone last year (mg)2,34 (2,84)sDMARDsMethotrexate104 (52%)Leflunomide29 (14,5%)Hydroxycloroquine9 (4,5%)bDMARDs89 (44,5%) TNFi41 (20,5%) Abatacept15 (7,5%) IL6i22 (11%) RTX11 (5,5%)JAKi26 (13%) Baricitinib11 (5,5%) Tofacitinib15 (7,5%)DAS 28-ESR3,1 (2,3, 3,9)SDAI7,85 (4,04, 13,41)HAQ0,88 (0,22, 1,5)RF (U/mL)51 (15, 164,25)Anti-CCP (U/mL)173 (22, 340)Patients showed higher intima-media (both right and left) thickness compared to controls (p<0.006). Moreover it was also related to the disease duration and DAS28 score (p<0.001). A higher plaque account was noted in cases(p<0.004) and it was also related to the disease duration (p<0.001).Conclusion:RA implies a higher CV risk. Traditional CV risk factors explains only partially the global risk. These findings support that RA acts as an independent cardiovascular risk factor.Disclosure of Interests:None declared

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Risk Factors for Methotrexate-Induced Lung Injury in Patients with Rheumatoid Arthritis: A Multicenter, Case-Control Study

Annals of Internal Medicine ◽

10.7326/0003-4819-127-5-199709010-00003 ◽

1997 ◽

Vol 127 (5) ◽

pp. 356 ◽

Cited By ~ 193

Author(s):

Graciela S. Alarcon

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Lung Injury ◽

Case Control Study ◽

Case Control ◽

Control Study

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The association between rheumatoid arthritis and periodontal disease in a population-based cross-sectional case-control study

BMC Rheumatology ◽

10.1186/s41927-020-00129-4 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Stefan Renvert ◽

Johan Sanmartin Berglund ◽

G. Rutger Persson ◽

Maria K. Söderlin

Keyword(s):

Rheumatoid Arthritis ◽

Periodontal Disease ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Cross Sectional ◽

Control Study

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Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies

Infection Control and Hospital Epidemiology ◽

10.1086/592412 ◽

2008 ◽

Vol 29 (12) ◽

pp. 1099-1106 ◽

Cited By ~ 528

Author(s):

Gopi Patel ◽

Shirish Huprikar ◽

Stephanie H. Factor ◽

Stephen G. Jenkins ◽

David P. Calfee

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Case Control Study ◽

Patient Survival ◽

Case Control ◽

Factors Associated ◽

Carbapenem Resistant ◽

Matched Case ◽

The Impact ◽

Control Study

Background.Carbapenem-resistant Klebsiella pneumoniae is an emerging healthcare-associated pathogen.Objective.To describe the epidemiology of and clinical outcomes associated with carbapenem-resistant K. pneumoniae infection and to identify risk factors associated with mortality among patients with this type of infection.Setting.Mount Sinai Hospital, a 1,171-bed tertiary care teaching hospital in New York City.Design.Two matched case-control studies.Methods.In the first matched case-control study, case patients with carbapenem-resistant K. pneumoniae infection were compared with control patients with carbapenem-susceptible K. pneumoniae infection. In the second case-control study, patients who survived carbapenem-resistant K. pneumoniae infection were compared with those who did not survive, to identify risk factors associated with mortality among patients with carbapenem-resistant K. pneumoniae infection.Results.There were 99 case patients and 99 control patients identified. Carbapenem-resistant K. pneumoniae infection was independently associated with recent organ or stem-cell transplantation (P = .008), receipt of mechanical ventilation (P = .04), longer length of stay before infection (P = .01), and exposure to cephalosporins (P = .02) and carbapenems (P < .001). Case patients were more likely than control patients to die during hospitalization (48% vs 20%; P < .001) and to die from infection (38% vs 12%; P < .001). Removal of the focus of infection (ie, debridement) was independently associated with patient survival (P = .002). The timely administration of antibiotics with in vitro activity against carbapenem-resistant K. pneumoniae was not associated with patient survival.Conclusions.Carbapenem-resistant K. pneumoniae infection is associated with numerous healthcare-related risk factors and with high mortality. The mortality rate associated with carbapenem-resistant K. pneumoniae infection and the limited antimicrobial options for treatment of carbapenem-resistant K. pneumoniae infection highlight the need for improved detection of carbapenem-resistant K. pneumoniae infection, identification of effective preventive measures, and development of novel agents with reliable clinical efficacy against carbapenem-resistant K. pneumoniae.

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