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Effect of Xerostomia on the Functional Capacity of Subjects with Rheumatoid Arthritis
Marília Lins E Silva1, Camila Nunes Carvalho1, Alessandra de Albuquerque Tavares Carvalho1
1From the Oral Medicine Unit, Department of Clinical and Preventive Dentistry, and the Rheumatology Unit, Clinics Hospital, Federal University of Pernambuco, Recife, Brazil.M. Lins e Silva, DDS, MSc, Oral Medicine Unit, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco; C.N. Carvalho, DDS, MSc, Oral Medicine Unit, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco; A.A. Carvalho, DDS, MSc, PhD, Oral Medicine Unit, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco; J.C. Leão, DDS, MSc, PhD, Oral Medicine Unit, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco; A.L. Duarte, DDS, MSc, PhD, Rheumatology Unit, Clinics Hospital, Federal University of Pernambuco; L.A. Gueiros, DDS, MSc, PhD, Oral Medicine Unit, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco.
Objective:
To evaluate the intensity of xerostomia and hyposalivation in subjects with rheumatoid arthritis (RA) as well as the effects of these conditions on functional incapacity and disease activity.
Methods:
The study sample comprised 236 individuals of both sexes who had RA. All the individuals were submitted to clinical evaluation and unstimulated sialometry. Functional capacity was determined by using the Health Assessment Questionnaire (HAQ), xerostomia was assessed using the Xerostomia Inventory, and disease activity was evaluated with the 28-joint Disease Activity Score (DAS28). The effect of Sjögren syndrome (SS) was analyzed, and the sample was divided into 2 groups: RA (191 subjects) and RA/SS (45 subjects).
Results:
The Xerostomia Inventory showed positive and significant correlation with fatigue (r = 0.243; p < 0.0001), number of painful joints (r = 0.218; p = 0.001), HAQ (r = 0.279; p < 0.0001), and DAS28 (r = 0.156; p < 0.0001). On regression analysis, both xerostomia (OR 3.89, 95% CI 1.84-8.23, p < 0.001) and DAS28 (for severe disease activity: OR 13.26, 95% CI 3.15-55.79, p < 0.001) showed influence on functional incapacity. Forty-five individuals (19.1%) presented with secondary SS, and having this diagnosis was not associated with disease activity or functional capacity.
Conclusion:
Xerostomia demonstrated an adverse effect on quality of life of subjects with RA, being associated with a reduction in functional capacity. In this clinical setting, xerostomia can be monitored as a marker of worse clinical evolution.
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