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Baron M, Hudson M, Dagenais M, Macdonald D, Gyger G, El Sayegh T, Pope J, Fontaine A, Masetto A, Matthews D, Sutton E, Thie N, Jones N, Copete M, Kolbinson D, Markland J, Nogueira-Filho G, Robinson D, Fritzler M, Wang M, Gornitsky M. Relationship Between Disease Characteristics and Oral Radiologic Findings in Systemic Sclerosis: Results From a Canadian Oral Health Study. Arthritis Care Res (Hoboken) 2016; 68:673-80. [DOI: 10.1002/acr.22739] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/11/2015] [Accepted: 09/15/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Murray Baron
- Jewish General Hospital and McGill University; Montreal Quebec Canada
| | - Marie Hudson
- Jewish General Hospital and McGill University; Montreal Quebec Canada
| | - Marie Dagenais
- Jewish General Hospital and McGill University; Montreal Quebec Canada
| | | | - Geneviève Gyger
- Jewish General Hospital and McGill University; Montreal Quebec Canada
| | | | - Janet Pope
- University of Western Ontario; London Ontario Canada
| | - Audrey Fontaine
- Clinique Dentaire Ayotte et Associatees; Sherbrooke Quebec Canada
| | | | | | | | - Norman Thie
- University of Alberta; Edmonton Alberta Canada
| | - Niall Jones
- University of Alberta; Edmonton Alberta Canada
| | - Maria Copete
- University of Saskatchewan; Saskatoon Saskatchewan Canada
| | - Dean Kolbinson
- University of Saskatchewan; Saskatoon Saskatchewan Canada
| | | | | | | | | | - Mianbo Wang
- Mianbo Wang, MD, Lady Davis Institute for Medical Research, Jewish General Hospital; Montreal Quebec Canada
| | - Mervyn Gornitsky
- Jewish General Hospital and McGill University; Montreal Quebec Canada
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Alhajeri H, Hudson M, Fritzler M, Pope J, Tatibouet S, Markland J, Robinson D, Jones N, Khalidi N, Docherty P, Kaminska E, Masetto A, Sutton E, Mathieu JP, Ligier S, Grodzicky T, LeClercq S, Thorne C, Gyger G, Smith D, Fortin PR, Larché M, Baron M. 2013 American College of Rheumatology/European League against rheumatism classification criteria for systemic sclerosis outperform the 1980 criteria: data from the Canadian Scleroderma Research Group. Arthritis Care Res (Hoboken) 2015; 67:582-7. [PMID: 25233870 DOI: 10.1002/acr.22451] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 08/12/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The goal of this study was to determine the sensitivity of the new 2013 classification criteria for systemic sclerosis (SSc; scleroderma) in an independent cohort of SSc subjects and to assess the contribution of individual items of the criteria to the overall sensitivity. METHODS SSc subjects from the Canadian Scleroderma Research Group cohort were assessed. Sensitivity was determined in several subgroups of patients. In patients without the criterion of skin thickening proximal to the metacarpophalangeal (MCP) joints, we recalculated sensitivity after removing the individual criterion. RESULTS A total of 724 SSc patients were included. Most were women (86%), mean age was 55.8 years, mean disease duration was 10.9 years, and 59% had limited cutaneous SSc (lcSSc). Overall, the sensitivity of the 2013 criteria was 98.3% compared to 88.3% for the 1980 criteria. This pattern was consistent among those with lcSSc (98.8% versus 85.6%), anticentromere antibodies (98.9% versus 79.8%), disease duration ≤3 years (98.7% versus 84.7%), and no skin involvement proximal to the MCP joints (97% versus 60%). In the latter subgroup, removing Raynaud's phenomenon and sclerodactyly from the criteria reduced the sensitivity to 77% and 79%, respectively. Removing both sclerodactyly and puffy fingers reduced the sensitivity to 62%. CONCLUSION The 2013 SSc classification criteria classify more SSc patients than the 1980 criteria. The improvement in sensitivity is most striking in those with lcSSc, especially those without skin involvement proximal to the MCP joints. The addition of Raynaud's phenomenon and puffy fingers to the 2013 criteria accounts for important gains in sensitivity.
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Affiliation(s)
- Hebah Alhajeri
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada
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Baron M, Hudson M, Tatibouet S, Steele R, Lo E, Gravel S, Gyger G, El Sayegh T, Pope J, Fontaine A, Masetto A, Matthews D, Sutton E, Thie N, Jones N, Copete M, Kolbinson D, Markland J, Nogueira G, Robinson D, Fritzler M, Gornitsky M. Relationship between disease characteristics and orofacial manifestations in systemic sclerosis: Canadian Systemic Sclerosis Oral Health Study III. Arthritis Care Res (Hoboken) 2015; 67:681-90. [PMID: 25303223 PMCID: PMC4464822 DOI: 10.1002/acr.22490] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 09/09/2014] [Accepted: 09/30/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Systemic sclerosis (SSc; scleroderma) is associated with decreased saliva production and interincisal distance, more missing teeth, and periodontal disease. We undertook this study to determine the clinical correlates of SSc with these oral abnormalities. METHODS Subjects were recruited from the Canadian Scleroderma Research Group cohort. Detailed dental and clinical examinations were performed according to standardized protocols. Associations between dental abnormalities and selected clinical and serologic manifestations of SSc were examined. RESULTS One hundred sixty-three SSc subjects were included: 90% women, mean ± SD age 56 ± 11 years, mean ± SD disease duration 14 ± 8 years, 72% with limited cutaneous disease, and 28% with diffuse cutaneous disease. Decreased saliva production was associated with Sjögren's syndrome-related autoantibodies (β = -43.32; 95% confidence interval [95% CI] -80.89, -5.75), but not with disease severity (β = -2.51; 95% CI -8.75, 3.73). Decreased interincisal distance was related to disease severity (β = -1.02; 95% CI -1.63, -0.42) and the modified Rodnan skin thickness score (β = -0.38; 95% CI -0.53, -0.23). The number of missing teeth was associated with decreased saliva production (relative risk [RR] 0.97; 95% CI 0.94, 0.99), worse hand function (RR 1.52; 95% CI 1.13, 2.02), and the presence of gastroesophageal reflux disease (GERD; RR 1.68 [95% CI 1.14, 2.46]). No clinical or serologic variables were correlated with periodontal disease. CONCLUSION In SSc, diminished interincisal distance is related to overall disease severity. Decreased saliva production is related to concomitant Sjögren's syndrome antibodies. Tooth loss is associated with poor upper extremity function, GERD, and decreased saliva. The etiology of excess periodontal disease is likely multifactorial and remains unclear.
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Affiliation(s)
- Murray Baron
- Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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Dagenais M, MacDonald D, Baron M, Hudson M, Tatibouet S, Steele R, Gravel S, Mohit S, El Sayegh T, Pope J, Fontaine A, Masseto A, Matthews D, Sutton E, Thie N, Jones N, Copete M, Kolbinson D, Markland J, Nogueira-Filho G, Robinson D, Gornitsky M. The Canadian Systemic Sclerosis Oral Health Study IV: oral radiographic manifestations in systemic sclerosis compared with the general population. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:104-11. [PMID: 25959972 DOI: 10.1016/j.oooo.2015.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/20/2015] [Accepted: 03/09/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of this study was to compare oral radiologic abnormalities associated with systemic sclerosis (SSc) against abnormalities in the general population. STUDY DESIGN Patients with SSc and healthy controls were enrolled in a multi-site cross-sectional study. Included in the radiology examination were a panoramic radiograph, four bitewings, and an anterior mandibular periapical radiograph. Radiographs were evaluated by two oral and maxillofacial radiologists tested for interobserver and intraobserver reliability. Chi-squared tests, Fisher exact tests, and Mann Whitney U tests were used to summarize the radiologic manifestations of patients and controls. RESULTS We assessed 163 SSc patients and 231 controls. Widening of the periodontal ligament space (PLS) (P < .001), with higher percentage of teeth with PLS widening (P < .001), was significantly more frequent in patients with SSc than in controls. The most significant differences between the two groups were found in the molars and premolars (P < .001). Moreover, 26% of the patients with SSc had a periapical PLS greater than 0.19 mm compared with 13% of the controls (P = .003). Patients with SSc had significantly more erosions compared with controls (14.5% vs. 3.6%; P < .001), mostly in the condyles (P = .022), coronoid processes (P = .005) and other locations (P = .012). CONCLUSION Patients with SSc had more teeth with PLS widening and erosions of the mandible compared with controls.
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Affiliation(s)
- Marie Dagenais
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1
| | - David MacDonald
- Faculty of Dentistry, Division of Oral & Maxillofacial Radiology, University of British Columbia, Room 380, J.B. Macdonald Building, 2199 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3
| | - Murray Baron
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-725, Montreal, Quebec H3T 1E2; Division of Rheumatology, Faculty of Medicine, McGill University, MUHC-MGH, Room A6.123, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4
| | - Marie Hudson
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-725, Montreal, Quebec H3T 1E2; Division of Rheumatology, Faculty of Medicine, McGill University, MUHC-MGH, Room A6.123, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4
| | - Solène Tatibouet
- Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, 3755 Côte Ste-Catherine, Montreal, Quebec H3T 1E2
| | - Russell Steele
- Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, 3755 Côte Ste-Catherine, Montreal, Quebec H3T 1E2; Department of Mathematics and Statistics, McGill University, Burnside Hall, Room 1005, 805 Sherbrooke Street West, Montreal, Quebec, H3A 0B9
| | - Sabrina Gravel
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-725, Montreal, Quebec H3T 1E2
| | - Shrisha Mohit
- Department of Dentistry, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-024, Montreal, Quebec H3T 1E2
| | - Tarek El Sayegh
- School of Dentistry, University of Western Ontario, Dental Sciences Building, Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1
| | - Janet Pope
- Division of Rheumatology, Department of Medicine, University of Western Ontario, Room 3700, Clinical Skills Building, London, Ontario N6A 5C1
| | - Audrey Fontaine
- Dentistry, Clinique Dentaire Ayotte et associées, 91 Rue Peel, bureau 300, Sherbrooke, Quebec J1H 4J9
| | - Ariel Masseto
- Department of Rheumatology, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Sherbrooke, Quebec J1H 5N4
| | - Debora Matthews
- Department of Periodontology, Faculty of Dentistry, Dentistry Building, Dalhousie University 5981 University Avenue, PO Box 15000, Halifax, Nova Scotia B3H 4R2
| | - Evelyn Sutton
- Division of Rheumatology, Faculty of Medicine, Dalhousie University, 1459 Oxford Street, Halifax, Nova Scotia B3H 4R2
| | - Norman Thie
- Division of Oro-facial Pain, School of Dentistry, University of Alberta, Edmonton, Alberta, Edmonton Clinic Health Academy, 5th Floor, 11405-87 Avenue NW, Edmonton, Alberta T6G 1 C9
| | - Niall Jones
- Department of Medicine, University of Alberta, Edmonton, Alberta, Edmonton Clinic Health Academy, 5th Floor, 11405 - 87 Avenue NW, Edmonton, Alberta T6G 1C9
| | - Maria Copete
- Department of Pathology, College of Dentistry, University of Saskatchewan, 174 Dental Clinic Building, 105 Wiggins Road, Saskatoon, Saskatchewan S7N 5E4
| | - Dean Kolbinson
- Department of Pathology, College of Dentistry, University of Saskatchewan, 174 Dental Clinic Building, 105 Wiggins Road, Saskatoon, Saskatchewan S7N 5E4
| | - Janet Markland
- Division of Rheumatology, College of Medicine, University of Saskatchewan, 5 D40 Health Sciences Building, 107 Wiggins Road, Saskatoon, SK S7N 5E5
| | - Getulio Nogueira-Filho
- Department of Periodontology, Faculty of Dentistry, D 212, 780 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba R3T 2N2; Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ontario M5G 1G6
| | - David Robinson
- Rheumatology, Faculty of Medicine, University of Manitoba, 260 Brodie Centre, 727 McDermot Avenue, Winnipeg, Manitoba R3E 3P5
| | - Mervyn Gornitsky
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1; Department of Dentistry, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-024, Montreal, Quebec H3T 1E2.
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Baron M, Hudson M, Tatibouet S, Steele R, Lo E, Gravel S, Gyger G, El Sayegh T, Pope J, Fontaine A, Masetto A, Matthews D, Sutton E, Thie N, Jones N, Copete M, Kolbinson D, Markland J, Nogueira-Filho G, Robinson D, Gornitsky M. The Canadian systemic sclerosis oral health study II: the relationship between oral and global health-related quality of life in systemic sclerosis. Rheumatology (Oxford) 2014; 54:692-6. [PMID: 25288781 DOI: 10.1093/rheumatology/keu396] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Both oral and global health-related quality of life (HRQoL) are markedly impaired in SSc. In this study we aimed to determine the degree of association between oral HRQoL and global HRQoL in SSc. METHODS Subjects were recruited from the Canadian Scleroderma Research Group registry. Global HRQoL was measured using the Medical Outcomes Trust 36-item Short Form Health Survey (SF-36) and oral HRQoL with the Oral Health Impact Profile (OHIP). The Medsger Disease Severity Score was used to determine organ involvement. Multivariate regression models determined the independent association of the OHIP with the SF-36 after adjusting for confounders. RESULTS This study included 156 SSc subjects. The majority (90%) were women, with a mean age of 56 years, mean disease duration 13.8 years (s.d. 8.5) and 29% of the subjects had dcSSc. Mean total OHIP score was 40.8 (s.d. 32.4). Mean SF-36 mental component summary (MCS) score was 49.7 (s.d. 11.1) and physical component summary (PCS) score was 37.0 (s.d. 10.7). In adjusted analyses, the total OHIP score was significantly associated with the SF-36 MCS and PCS, accounting for 9.7% and 5.6% of their respective variances. Measures of disease severity were not related to OHIP score. CONCLUSION Oral HRQoL in SSc is independently associated with global HRQoL. Oral HRQoL, however, is not related to physician-assessed disease severity. This suggests that physicians may be disregarding issues related to oral health. HRQoL is an additional dimension of HRQoL not captured by generic instruments such as the SF-36.
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Affiliation(s)
- Murray Baron
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada. Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Period
| | - Marie Hudson
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada. Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Period
| | - Solène Tatibouet
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Russell Steele
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada. Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Period
| | - Ernest Lo
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Sabrina Gravel
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Geneviève Gyger
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada. Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Period
| | - Tarek El Sayegh
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Janet Pope
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Audrey Fontaine
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Ariel Masetto
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Debora Matthews
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Evelyn Sutton
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Norman Thie
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Niall Jones
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Maria Copete
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Dean Kolbinson
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Janet Markland
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Getulio Nogueira-Filho
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - David Robinson
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Mervyn Gornitsky
- Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, McGill University, Montreal, QC, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Montreal, Department of Mathematics and Statistics, Dentistry, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, ON, Dentistry, Clinique Dentaire Ayotte et associées, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Division of Periodontics and Oro-facial Pain, Faculty of Dentistry, Dalhousie University, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, TMD/Orofacial Pain Graduate Program, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, College of Dentistry, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Department of Periodontology, Faculty of Dentistry, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, MB and Department of Dentistry, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada
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Baron M, Hudson M, Tatibouet S, Steele R, Lo E, Gravel S, Gyger G, Sayegh TE, Pope J, Fontaine A, Masseto A, Matthews D, Sutton E, Thie N, Jones N, Copete M, Kolbinson D, Markland J, Nogueira-Filho G, Robinson D, Gornitsky M. The Canadian systemic sclerosis oral health study: orofacial manifestations and oral health-related quality of life in systemic sclerosis compared with the general population. Rheumatology (Oxford) 2014; 53:1386-94. [PMID: 24464709 PMCID: PMC4103515 DOI: 10.1093/rheumatology/ket441] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 11/12/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare oral abnormalities and oral health-related quality of life (HRQoL) of patients with SSc with the general population. METHODS SSc patients and healthy controls were enrolled in a multisite cross-sectional study. A standardized oral examination was performed. Oral HRQoL was measured with the Oral Health Impact Profile (OHIP). Multivariate regression analyses were performed to identify associations between SSc, oral abnormalities and oral HRQoL. RESULTS We assessed 163 SSc patients and 231 controls. SSc patients had more decayed teeth (SSc 0.88, controls 0.59, P = 0.0465) and periodontal disease [number of teeth with pocket depth (PD) >3 mm or clinical attachment level (CAL) ≥5.5 mm; SSc 5.23, controls 2.94, P < 0.0001]. SSc patients produced less saliva (SSc 147.52 mg/min, controls 163.19 mg/min, P = 0.0259) and their interincisal distance was smaller (SSc 37.68 mm, controls 44.30 mm, P < 0.0001). SSc patients had significantly reduced oral HRQoL compared with controls (mean OHIP score: SSc 41.58, controls 26.67, P < 0.0001). Multivariate regression analyses confirmed that SSc was a significant independent predictor of missing teeth, periodontal disease, interincisal distance, saliva production and OHIP scores. CONCLUSION Subjects with SSc have impaired oral health and oral HRQoL compared with the general population. These data can be used to develop targeted interventions to improve oral health and HRQoL in SSc.
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Affiliation(s)
- Murray Baron
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Marie Hudson
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Solène Tatibouet
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Russell Steele
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Ernest Lo
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Sabrina Gravel
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Geneviève Gyger
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Tarek El Sayegh
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Janet Pope
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Audrey Fontaine
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Ariel Masseto
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Debora Matthews
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Evelyn Sutton
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Norman Thie
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Niall Jones
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Maria Copete
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Dean Kolbinson
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Janet Markland
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Getulio Nogueira-Filho
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - David Robinson
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
| | - Mervyn Gornitsky
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, Division of Rheumatology, Faculty of Medicine, McGill University, Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, Department of Mathematics and Statistics, McGill University, Montreal, Quebec, School of Dentistry, University of Western Ontario, Division of Rheumatology, Department of Medicine, University of Western Ontario, London, Ontario, Department of Rheumatology, Université de Sherbrooke, Sherbrooke, Quebec, Department of Periodontology, Faculty of Dentistry, Division of Rheumatology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Division of Oro-facial Pain, School of Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Department of Pathology, College of Dentistry, University of Saskatchewan, Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Department of Periodontology, Rheumatology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba and Department of Dentistry, SMBD Jewish General Hospital, Montreal, Quebec, Canada
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Mayes M, Bossini-Castillo L, Gorlova O, Martin J, Zhou X, Chen W, Assassi S, Ying J, Tan F, Arnett F, Reveille J, Guerra S, Teruel M, Carmona F, Gregersen P, Lee A, López-Isac E, Ochoa E, Carreira P, Simeón C, Castellví I, González-Gay M, Zhernakova A, Padyukov L, Alarcón-Riquelme M, Wijmenga C, Brown M, Beretta L, Riemekasten G, Witte T, Hunzelmann N, Kreuter A, Distler JH, Voskuyl AE, Schuerwegh AJ, Hesselstrand R, Nordin A, Airó P, Lunardi C, Shiels P, van Laar JM, Herrick A, Worthington J, Denton C, Wigley FM, Hummers LK, Varga J, Hinchcliff ME, Baron M, Hudson M, Pope JE, Furst DE, Khanna D, Phillips K, Schiopu E, Segal BM, Molitor JA, Silver RM, Steen VD, Simms RW, Lafyatis RA, Fessler BJ, Frech TM, AlKassab F, Docherty P, Kaminska E, Khalidi N, Jones HN, Markland J, Robinson D, Broen J, Radstake TR, Fonseca C, Koeleman BP, Martin J, Ortego-Centeno N, Ríos R, Callejas J, Navarrete N, García Portales R, Camps M, Fernández-Nebro A, González-Escribano M, Sánchez-Román J, García-Hernández F, Castillo M, Aguirre M, Gómez-Gracia I, Fernández-Gutiérrez B, Rodríguez-Rodríguez L, Vicente E, Andreu J, Fernández de Castro M, García de la Peña P, López-Longo F, Martínez L, Fonollosa V, Espinosa G, Tolosa C, Pros A, Rodríguez Carballeira M, Narváez F, Rubio Rivas M, Ortiz Santamaría V, Díaz B, Trapiella L, Freire M, Sousa A, Egurbide M, Fanlo Mateo P, Sáez-Comet L, Díaz F, Hernández V, Beltrán E, Román-Ivorra J, Grau E, Alegre Sancho J, Blanco García F, Oreiro N, Fernández Sueiro L. Immunochip analysis identifies multiple susceptibility loci for systemic sclerosis. Am J Hum Genet 2014; 94:47-61. [PMID: 24387989 DOI: 10.1016/j.ajhg.2013.12.002] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 12/03/2013] [Indexed: 12/12/2022] Open
Abstract
In this study, 1,833 systemic sclerosis (SSc) cases and 3,466 controls were genotyped with the Immunochip array. Classical alleles, amino acid residues, and SNPs across the human leukocyte antigen (HLA) region were imputed and tested. These analyses resulted in a model composed of six polymorphic amino acid positions and seven SNPs that explained the observed significant associations in the region. In addition, a replication step comprising 4,017 SSc cases and 5,935 controls was carried out for several selected non-HLA variants, reaching a total of 5,850 cases and 9,401 controls of European ancestry. Following this strategy, we identified and validated three SSc risk loci, including DNASE1L3 at 3p14, the SCHIP1-IL12A locus at 3q25, and ATG5 at 6q21, as well as a suggested association of the TREH-DDX6 locus at 11q23. The associations of several previously reported SSc risk loci were validated and further refined, and the observed peak of association in PXK was related to DNASE1L3. Our study has increased the number of known genetic associations with SSc, provided further insight into the pleiotropic effects of shared autoimmune risk factors, and highlighted the power of dense mapping for detecting previously overlooked susceptibility loci.
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Sabbagh Z, Markland J, Vatanparast H. Vitamin D status is associated with disease activity among rheumatology outpatients. Nutrients 2013; 5:2268-75. [PMID: 23803739 PMCID: PMC3738972 DOI: 10.3390/nu5072268] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/06/2013] [Accepted: 06/06/2013] [Indexed: 11/29/2022] Open
Abstract
The co-existence of high prevalence of vitamin D inadequacy among Canadians and high prevalence of systematic autoimmune rheumatic diseases (SARDs) raise the question on relationship between the two situations. Objective: To determine vitamin D status in known cases of common SARDs and compare to those with non-autoimmune diseases; further, to evaluate the impact of vitamin D on disease activity in rheumatoid arthritis (RA) cases. Methods: In a retrospective case-control study design, we evaluated 116 patients in a community clinic classified in two groups, Control group: patients with non-rheumatic disease (n = 56), and Case group: those with rheumatic diseases (n = 60). We compared plasma vitamin D status (25(OH)D), indicators of disease activity and other potential confounders. Further, we determined factors associated with disease activity in RA cases. Results: The plasma 25(OH)D was significantly lower in Case group (64.8 ± 29.8) compared to Control group (86.8 ± 37.7). High number of SARDs outpatients 56%) had considerably low plasma 25(OH)D concentration. RA cases with low plasma 25(OH)D had over five times higher risk of disease activity (OR = 5.15 95% CI 1.16, 22.9; p = 0.031). Conclusion: Inadequate vitamin D status in SARDs cases, along with considerably strong association with disease activity in RA cases, indicate the need for proper evaluation of vitamin D status in this clinical population. Moreover, appropriate training should be given to the patients to ensure the intake of the recommended amount of vitamin D per day through diet or supplement.
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Affiliation(s)
- Zohreh Sabbagh
- Department of Internal Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK S7J 5B6, Canada; E-Mails: (Z.S.); (J.M.)
| | - Janet Markland
- Department of Internal Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK S7J 5B6, Canada; E-Mails: (Z.S.); (J.M.)
| | - Hassanali Vatanparast
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, School of Public Health, University of Saskatchewan; Saskatoon SK S7N 5C9, Canada
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-306-996-6341; Fax: +1-306-966-6377
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Hitchon CA, Chandad F, Ferucci ED, Willemze A, Ioan-Facsinay A, van der Woude D, Markland J, Robinson D, Elias B, Newkirk M, Toes RM, Huizinga TWJ, El-Gabalawy HS. Antibodies to porphyromonas gingivalis are associated with anticitrullinated protein antibodies in patients with rheumatoid arthritis and their relatives. J Rheumatol 2010; 37:1105-12. [PMID: 20436074 DOI: 10.3899/jrheum.091323] [Citation(s) in RCA: 161] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Anticitrullinated protein antibodies (ACPA) are relatively specific for rheumatoid arthritis (RA), and predate disease. The oral pathogen Porphyromonas gingivalis may play a role in breaking immune tolerance to citrullinated antigens. We studied a cohort of patients with RA and their relatives looking for associations between anti-P. gingivalis antibodies and ACPA. METHODS Patients with RA (n = 82) and their relatives (n = 205) from a North American Native (NAN) population were studied, along with 47 NAN and 60 non-NAN controls. IgM and IgA rheumatoid factor (RF) were tested by nephelometry and ELISA. Second-generation anticyclic citrullinated peptide (anti-CCP2) isotypes and IgG anti-P. gingivalis lipopolysaccharides were tested by ELISA. HLA-DRB1 typing was performed by sequencing. Oral hygiene and smoking habits were assessed by questionnaires. RESULTS Autoantibody frequency in patients with RA and relatives: ACPA 91% vs 19%, respectively; IgM RF 82% vs 17%; IgA RF 48% vs 22%. Anti-P. gingivalis levels were higher in patients with RA compared to relatives and controls (p = 0.005) and higher in ACPA-positive patients with RA than in ACPA-negative patients with RA (p = 0.04) and relatives (p < 0.001), but comparable in RF-positive and RF-negative patients and relatives. Poor oral hygiene and smoking were prevalent, but with no clear association with autoantibodies. Relatives with 2 shared-epitope alleles were more likely to be ACPA-positive (OR 2.5, p = 0.02). CONCLUSION In a genetically predisposed population of NAN patients with RA and their relatives, anti-P. gingivalis antibodies were associated with ACPA. These findings suggest that immune responses to P. gingivalis may be involved in breaking immune tolerance to citrullinated antigens.
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Bernatsky S, Hudson M, Pope J, Vinet E, Markland J, Robinson D, Jones N, Docherty P, Abu-Hakima M, LeClercq S, Dunne J, Smith D, Mathieu JP, Khalidi N, Sutton E, Baron M. Assessment of reproductive history in systemic sclerosis. ACTA ACUST UNITED AC 2008; 59:1661-4. [DOI: 10.1002/art.24198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bernatsky S, Hudson M, Pope J, Markland J, Robinson D, Jones N, Docherty P, Abu-Hakima M, LeClerc S, Dunne J, Smith CD, Sutton E, Khalidi N, Mathieu JP, Masetto A, Ligier S, Kaminska E, Baron M. Reports of abnormal cervical cancer screening tests in systemic sclerosis. Rheumatology (Oxford) 2008; 48:149-51. [DOI: 10.1093/rheumatology/ken442] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ioan-Facsinay A, Willemze A, Robinson DB, Peschken CA, Markland J, van der Woude D, Elias B, Ménard HA, Newkirk M, Fritzler MJ, Toes REM, Huizinga TWJ, El-Gabalawy HS. Marked differences in fine specificity and isotype usage of the anti-citrullinated protein antibody in health and disease. ACTA ACUST UNITED AC 2008; 58:3000-8. [DOI: 10.1002/art.23763] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Edworthy S, Zummer M, Garner S, Boire G, Leclercq S, Bykerk V, Kraag G, Markland J, Thomas D, Thomson J, Henderson J. Smoldering rheumatoid arthritis: is the Canadian healthcare system neglecting a significant disease population? J Rheumatol 2008; 35:1506-1512. [PMID: 18597407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To investigate rheumatology practice in Canada with regard to evaluating disease activity status and treatment regimens in patients with rheumatoid arthritis (RA). It was hypothesized that patients with "smoldering" disease activity were not being adequately treated. METHODS Rheumatologists were invited to participate by the Canadian Rheumatology Association in an audit entitled the Assessment in Rheumatology (AIR) program. From across Canada, 65 rheumatologists participated. One thousand five hundred ninety-six consecutive patients with RA seen in regular clinics were classified according to 4 states of disease activity: remission, controlled adequately, smoldering, and uncontrolled. Demographics (age, sex, geographic region), therapy (nonsteroidal antiinflammatory drugs, disease modifying antirheumatic drugs, biologicals, steroids), joint counts (tender/swollen), comorbidity, and treatment decisions at the time of the visit were recorded. Data were collected at the time of the visit with personal digital assistants (PDA) and aggregated, without personal identifiers, for analysis in SPSS. RESULTS The majority of patients had "smoldering" (29%) or "uncontrolled" disease (23%), with the remainder in "remission" (15%) or "controlled adequately" (33%) at the time of their visit. Following the appointment, the uncontrolled group had a 100% increase (from 10.4% to 23.4%) in the addition of biological agents; however, there was no significant increase in the rates for those with smoldering disease (19.4% to 20.5%). CONCLUSION Despite Canada's universal healthcare system, current treatment regimens may not be optimized on the basis of disease activity. A large proportion of patients with RA (29%) seen in Canadian rheumatology practices may be experiencing unnecessary disease for a variety of reasons.
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Baron M, Sutton E, Hudson M, Thombs B, Markland J, Pope J, Robinson D, Jones N, Docherty P, Abu-Hakima M, LeClercq S, Smith D, Mathieu JP. The relationship of dyspnoea to function and quality of life in systemic sclerosis. Ann Rheum Dis 2007; 67:644-50. [PMID: 17728334 DOI: 10.1136/ard.2007.075721] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM Up to 50% of patients with systemic sclerosis (SSc) have complaints of dyspnoea. We evaluated the independent contributions of dyspnoea to function and health related quality of life (HRQoL) in SSc and also assessed the contributions of pulmonary hypertension, measured by the pulmonary artery systolic pressure (PASP), and interstitial lung disease, measured by the forced vital capacity (FVC), to dyspnoea. METHODS We assessed dyspnoea, PASP, FVC, function and HRQoL in a cohort of unselected patients with SSc. Multiple linear regression was used to assess the independent contributions of dyspnoea, PASP and FVC to function and HRQoL, after controlling for possible confounding variables. RESULTS A total of 194 patients with mean disease duration of 11.6 years were studied. Dyspnoea was a significant independent predictor of function and HRQoL. A model including age, gender, disease duration, disease severity and dyspnoea explained 33.3%, 10.6%, 39.2% and 29.4% of the variance of the Stanford Health Assessment Questionnaire, the Short-Form 36 (SF-36) mental component summary score, the SF-36 physical component summary score and the World Health Organization Disability Assessment Schedule II. PASP and FVC were significant independent predictors of dyspnoea but only 21.9% of the variance in dyspnoea was explained by age, gender, disease duration, FVC and PASP. The FVC was a significant independent predictor of function and HRQoL. CONCLUSION In an unselected population of SSc patients, dyspnoea is a very important contributor to function and HRQoL. Interstitial lung disease, as measured by the FVC, contributes significantly to the sense of dyspnoea, function and HRQoL in SSc. Pulmonary hypertension, assessed echocardiographically by the PASP, predicts the degree of dyspnoea but not function and HRQoL in SSc.
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Affiliation(s)
- M Baron
- McGill University, Montreal, Quebec, Canada.
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Santiago M, Baron M, Miyachi K, Fritzler MJ, Abu-Hakima M, Leclercq S, Bell M, Hudson M, Mathieu JP, Taillefer S, Jones N, Docherty P, Khraishi M, Markland J, Pope J, Robinson D, Smith D, Sutton E. A comparison of the frequency of antibodies to cyclic citrullinated peptides using a third generation anti-CCP assay (CCP3) in systemic sclerosis, primary biliary cirrhosis and rheumatoid arthritis. Clin Rheumatol 2007; 27:77-83. [PMID: 17570008 DOI: 10.1007/s10067-007-0656-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Revised: 05/16/2007] [Accepted: 05/18/2007] [Indexed: 12/12/2022]
Abstract
The objective was to investigate the frequency of anti-cyclic citrullinated peptides (CCP) antibodies in systemic sclerosis (SSc) and primary biliary cirrhosis (PBC), utilizing a new "third generation" anti-CCP ELISA (anti-CCP3) kit and a conventional anti-CCP2 assay. Patients with PBC, SSc, RA, and normal controls were included in the study. Serum samples were screened for autoantibodies by indirect immunofluorescence (IIF), antibodies to CCP by a second- and third-generation ELISA, antibodies to "scleroderma" antigens (CENP B, Scl-70, PM/Scl and fibrillarin-Scl-34) by a line immunoassay (LIA), and IgM RF by ELISA. The frequency of anti-CCP2 antibodies in SSc and PBC samples was 14.8% (11/74) and 6.2% (5/80), respectively, and the frequency of anti-CCP3 antibodies in SSc was 13.5% (10/74) and in PBC was 3.7% (3/80). By comparison, in the RA group the frequency of anti-CCP3 and anti-CCP2 antibodies was 79.1% (38/48) and 77% (37/48), respectively. Anti-CCP3 ELISA had a sensitivity, specificity, and positive and negative likelihood ratios (LR) of 79% (95% confidence interval [CI] = 64-89%), 93% (95% CI = 88-96%), 11.8 (95% CI = 6.8-20.3), and 0.22 (95% CI = 0.12-0.38), respectively. By comparison, the anti-CCP2 assay had a sensitivity, specificity, and positive and negative LRs of 77% (95% CI = 62-87), 90% (95% CI = 85-94), 8.3 (95% CI = 5.2-13.2), and 0.25 (95% CI = 0.15-0.42), respectively. In patients with SSc, there was an association of anti-CCP2 antibodies with the presence of arthritis, but there was no association of anti-CCP2 or anti-CCP3 with anti-CENP B, anti-Scl 70, or RF. This study confirmed the high specificity and sensitivity of both anti-CCP assays for the diagnosis of RA. The presence of anti-CCP antibodies in SSc was only correlated with the presence of arthritis.
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Affiliation(s)
- Mittermayer Santiago
- Servico de Reumatologia do Hospital do Santa Izabel, Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil
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Abstract
OBJECTIVE To examine the outcomes of calls to NHS Direct (NHS-D) in relation to attendance at the accident and emergency (A&E) department. DESIGN A prospective collection of data about consecutive calls to NHS-D North West Coast was matched with attendances at the A&E department over a period of 3 months. SETTING NHS-D Regional Trust and a large urban paediatric A&E department. PATIENTS Children and young adults aged <16 years living in local postal code areas. MAIN OUTCOME MEASURES To examine (1) whether advice given by NHS-D was followed and (2) the differences in disease severity and necessity of attendance of patients referred by NHS-D and those referred by general practitioners and self-presenters. RESULTS The relationship between the advice given and subsequent action is complex. Only 70% of calls advised to attend the A&E department did so. A further 1% (176) were advised not to attend the A&E department did in fact attend the department. Patients referred by NHS-D represented only 3.2% of department attendances. There was little difference in the triage categories of the presenting groups, but there were significantly less admissions (p<0.01) in the NHS-D group. CONCLUSIONS Delivering telephone advice about illness severity in children is difficult as visual clues are so important. More collaborative prospective studies are needed, including with primary care, to understand families' choices, and to refine and assess NHS-D's ability to discriminate those requiring further clinical assessment.
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Affiliation(s)
- B Stewart
- Accident and Emergency Department, Royal Liverpool Children's Hospital, Liverpool, UK.
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Pope JE, Bellamy N, Seibold JR, Baron M, Ellman M, Carette S, Smith CD, Chalmers IM, Hong P, O'Hanlon D, Kaminska E, Markland J, Sibley J, Catoggio L, Furst DE. A randomized, controlled trial of methotrexate versus placebo in early diffuse scleroderma. Arthritis Rheum 2001; 44:1351-8. [PMID: 11407694 DOI: 10.1002/1529-0131(200106)44:6<1351::aid-art227>3.0.co;2-i] [Citation(s) in RCA: 233] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Early diffuse scleroderma (systemic sclerosis; SSc) has no proven treatment. This study was undertaken to examine the efficacy of methotrexate (MTX) in improving the skin and other disease parameters in early diffuse SSc. METHODS Seventy-one patients with diffuse SSc of <3 years' duration were enrolled in a multicenter, randomized, placebo-controlled, double-blind trial. Thirty-five patients were treated with MTX and 36 with placebo. Treatment was administered for 12 months. The primary outcome measures were skin score (as determined with 2 different indices) and physician global assessment. RESULTS At baseline, there were no statistically significant differences in skin scores, carbon monoxide diffusing capacity (DLco), physician global assessment, or other secondary outcome measurements between the 2 treatment groups. At study completion, results slightly favored the MTX group (mean +/- SEM modified Rodnan skin score 21.4+/-2.8 in the MTX group versus 26.3+/-2.1 in the placebo group [P < 0.17]; UCLA skin score 8.8+/-1.2 in the MTX group versus 11.0+/-0.9 in the placebo group [P < 0.15]; DLco in the MTX group 75.7+/-4.6 versus 61.8+/-3.4 in the placebo group [P < 0.2]). In addition, physician global assessment results favored MTX (P < 0.035), whereas patient global assessment did not differ significantly between groups. When between-group differences for changes in scores from baseline to 12 months were examined using intent-to-treat methodology, MTX appeared to have a favorable effect on skin scores (modified Rodnan score -4.3 in the MTX group versus 1.8 in the placebo group [P < 0.009]; UCLA score -1.2 in the MTX group versus 1.2 in the placebo group [P < 0.02]), but differences in the degree of change in the DLco and physician global assessment were not significant. For the UCLA skin score, these differences in results were not statistically significant after adjustment for baseline differences in sex distribution and steroid use. Dropout rates were similar in the 2 groups. CONCLUSION Although results of this trial demonstrated a trend in favor of MTX versus placebo in the treatment of early diffuse SSc, the between-group differences were small and the power to rule out false-negative results was only 50%. Our findings do not provide evidence that MTX is significantly effective in the treatment of early diffuse SSc.
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Affiliation(s)
- J E Pope
- University of Western Ontario, London, Canada
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Nickless G, Henn DE, Riley JP, Phillips GF, Stockwell PB, Markland J. Book reviews. Analyst 1977. [DOI: 10.1039/an9770200070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sutton RW, Markland J, Barraclough A, Chapman WB. Investigations in the examination and on variations in the composition of milk. Part I. The determination of the Hortvet freezing-point. Analyst 1950. [DOI: 10.1039/an9507500042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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