Background: Systemic lupus erythematosus (SLE) is reported to have a high prevalence of periodontitis, suggesting an association with disease activity. However, the association between periodontitis and disease relapse has not been studied.

Objectives: We investigated the association between periodontal disease and SLE relapse in adult SLE patients.

Methods: The study design was a prospective observational study. The participants were SLE patients under 65 years who visited our department. The primary outcome was disease relapse of SLE. Disease relapse was defined as the appearance of deterioration in one or more organ systems that would necessitate treatment intensification [1]. Our main exposure was periodontitis assessed with a pocket of depth, attachment loss by dentists. We divided a grade of periodontitis into four categories (Non-periodontitis, Mild periodontitis, Moderate periodontitis, Severe periodontitis) by Centers for Disease Control and Prevention – The American Academy of Periodontology (CDC-APP) definition [2]. Stastiscal analysis: we analyzed the distribution of periodontal disease severity and examined the patient backgrounds corresponding to each level of disease severity. Therefore, logistic regression analysis was performed to assess the association between periodontitis and relapse of SLE. The co-variables selected were as follows: age, sex, current smoking status, current prednisolone dose and current immunosuppressant use. To deal with missing values, we used multivariable multiple imputations with chained equations methods. Two-sided P<0.05 was considered statistically significant. STATA 17.0 was used for statistical analysis.

Results: The primary analysis included 120 patients with a mean age of 40.2 years and 88.3% women. The mean follow-up period was 4.5 years. The prevalence of periodontitis by severity was 31.4% for no periodontal disease, 1.7% for mild disease, 59.3% for moderate disease, and 7.6% for severe disease. SLE relapse was observed in 35.6%. Logistic regression adjusted for confounding factors showed that relapse for the no periodontitis group was significantly higher than for the mild odds ratio (OR) 1.2 (95% confidential interval (CI): 0.07 - 22.4), moderate OR 0.6 (95%CI: 0.26 - 1.5), and severe OR 2.6 (95%CI: 0.48 – 14.0).

Conclusion: In this study, we found that 70% of the SLE patients in the study population had periodontitis, which is higher than in the general population. Furthermore, we found no significant association between the severity of periodontitis and SLE relapse. However, it is considered significant that an examination was able to be carried out regarding the association between the severity of periodontal disease and the relapse of systemic lupus erythematosus.

REFERENCES: [1] Ruperto N, Hanrahan LM, Alarcón GS, et.al. Lupus. 2011;20:453-62.

[2] Eke PI, Page RC, Wei L, et.al. J Periodontol. 2012;83:1449-54.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.