Rheumatoid Arthritis Clinical Trial
Official title:
RCT: Evaluating the Effect of Oral Care for Periodontitis in Rhematoid Arthritis Patients in Uganda
this will be an RCT. to determine if non-surgical treatment for periodontitis can improve the disease activity score in 28 joints of rheumatoid arthritis in an African setting. Rheumatoid arthritis patients with periodontal disease will be randomised into an immediate intervention arm and a delayed intervention arm and both groups will be followed for two three monthly periods
1. RESEARCH QUESTIONS
- What is the prevalence of periodontitis among rthematoid arthritis patients
attending the Mulago rheumatology clinic?
- Does non-surgical treatment for periodontitis improve the disease activity score in
28 joints of rheumatoid arthritis in this local setting?
2. Problem statement It has been shown that intervention with nonsurgical treatment of
periodontitis improved the periodontal condition of patients with periodontitis and RA,
with beneficial effects upon the clinical and laboratory test parameters, disease
activity scores in 28 joints (DAS28) and erythrocyte sedimentation rate (ESR). However,
all the studies included in the reviews involved small samples sizes and follow-up
periods of less than 6 months. And locally to our knowledge there is currently no
published information looking at the role of periodontal disease among Ugandans with
rheumatoid arthritis.
3. METHODS Objective 1 will be addressed with a cross sectional study design while
objective 2 will be a randomized control intervention on a fresh sample of patients from
the clinic who will be randomly assigned using computer generated random numbers.
Population : To address the objective 1 a total sample size of 146 randomly selected study
participants.
For objective 2 the target sample size of 304 individuals or 152 individuals per group.
Procedures: On arrival to the dental clinic, the selected and previously consented
participants will undergo a standardized interview. This will be followed by an oral
examination to assess for: registration of plaque, bleeding on probing, probing depth and
followed with the calculation of the Periodontal inflamed surface area score and clinical
attachment loss, pick crevicular fluid using paper point for follow-up confirmatory
polymerase chain reactions (PCR), quantification with quantitative real-time PCR (QPCR)
experiments for P. gingivalis. At the end of the examination a peripheral blood sample will
be obtained for: erythrocyte sedimentation rate to be factored in the determination of DAS 28
score. The remaining blood sample will be stored in the department of Anatomy for further
studies latter pertaining to PD and RA.
Objective 2 RCT study Participants will be randomized into an immediate intervention arm and
a delayed intervention arm.
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