Jon T Giles

[Jon T Giles @JonTGiles1]

Thanks Everyone! #EULARJC

[Jon T Giles @JonTGiles1]

There is no downside to promoting oral health in our patients. Even without RCTs, knowing that there are possible links between oral health and RA outcomes is enough reason to have discussions with our patients with periodontal disease, and encourage treatment #EULARJC

[Jon T Giles @JonTGiles1]

We did not find a difference of effect between seropositive and seronegative patients in our study #EULARJC

[Jon T Giles @JonTGiles1]

Question 2 would not be a difficult study to design. Question 1 is more challenging #EULARJC

[Jon T Giles @JonTGiles1]

I hope that is the case! #EULARJC

[Jon T Giles @JonTGiles1]

@MProtopopov Of course--our data don't prove this. but can be the basis for future interventional studies

[Jon T Giles @JonTGiles1]

@EULAR_JC @MaxKonigMD There are molecular mechanistic implications--for which addition study into the why and how can be designed. Clinically, our findings might suggest that periodontal disease treatment or prevention may reduce atherosclerosis burden in RA patients

[Jon T Giles @JonTGiles1]

@EULAR_JC @MaxKonigMD Long story short was that anti-Aa/LtxA was associated with measures of atherosclerosis in every vascular bed---an effect not confounded by CVD risk factors or RA factors. anti-Pg was decidedly not associated with any atherosclerosis measure

[Jon T Giles @JonTGiles1]

@EULAR_JC @MaxKonigMD almost all of the patients who were anti-Aa positive also had anti-LtxA---but not all of them.

[Jon T Giles @JonTGiles1]

@EULAR_JC @MaxKonigMD We used the presence of either anti-Aa or anti-LtxA to indicate whether a person had been exposed to Aa, and presence of anti-Pg to indicate exposure to Pg

[Jon T Giles @JonTGiles1]

@msokolova_rheum @MaxKonigMD @EULAR_JC Agreed--one thing we didn't have for this study were people without RA. So we can't say for sure whether we would not find the same associations in other non-RA populations. Based on the literature, our effect may be a little more than previously reported.

[Jon T Giles @JonTGiles1]

@MProtopopov @MaxKonigMD @EULAR_JC The link between Aa/LtxA is recognized in the general population, as well. The effect may be heightened in RA because
1) anti-Aa/anti/LtxA are more prevalent in RA patients
2) RA patients are more prone to atherosclerosis

[Jon T Giles @JonTGiles1]

@EULAR_JC @MaxKonigMD We used multiple measures of atherosclerosis in order to get an idea of which vascular territories were involved. We had measures of cardiac atherosclerosis (CAC score), carotid atherosclerosis (from U/S) and peripheral artery disease (using doppler ultrasound)

[Jon T Giles @JonTGiles1]

@EULAR_JC @MaxKonigMD We had measures of atherosclerosis already in the ESCAPE-RA CVD study and had measured anti-Pg, anti-Aa, and LtxA from the same study for a different project---so it was the perfect setting to look at these together in the context of RA

[Jon T Giles @JonTGiles1]

@EULAR_JC @MaxKonigMD Links between RA and atherosclerosis are well known and links between RA and periodontal disease are well know--but the link between periodontal disease and atherosclerosis in RA have not been well studied

[Jon T Giles @JonTGiles1]

@rheumpatient @EULAR_JC They are interesting, but not conflicting!

[Jon T Giles @JonTGiles1]

@EULAR_JC Hi--I'm Jon Giles. No conflicts related to this paper

[Jon T Giles @JonTGiles1]

@EULAR_JC @JohnsHopkins Glad to be here!