Multivariate analysis of treatment choices, disease activity, comorbidities, and oral impairments in rheumatoid arthritis patients.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects the synovial joints and is often associated with multiple comorbidities. Emerging evidence suggests a bidirectional link between RA and periodontal inflammation, wherein shared inflammatory mediators contribute to disease severity and therapeutic outcomes. OBJECTIVE: The objective of the study was to examine the relationships among demographic and clinical characteristics, comorbidities, periodontal impairment assessed using Russell's Periodontal Index, systemic disease activity measured by Disease Activity Score (DAS28) and C-reactive protein (CRP), and treatment regimens in patients with RA. MATERIALS AND METHODS: A cross-sectional cohort of 33 patients clinically diagnosed with RA (21 seropositive and 12 seronegative) was analyzed. Demographic, serological, and clinical data were retrieved from medical records and verified during follow-up consultations. Russell's Index was used to quantify periodontal involvement, whereas disease activity was assessed using the DAS28 score, which incorporates CRP levels. Details of comorbidities and prescribed treatments, hydroxychloroquine (HCQ), corticosteroids, or combination therapy, were documented. Descriptive and correlational analyses were performed to evaluate associations between disease activity, oral impairment, and therapeutic approach. RESULTS: The cohort comprised 91% females, with a mean age of 46.5 ± 9.8 years. Seropositive RA was identified in 64% of patients. The mean Russell's Index was 2.42 in the RA+ and 1.92 in the RA- groups, showing greater periodontal impairment in seropositive cases. Hypertension (12%), diabetes (6%), and hypothyroidism (6%) were the most frequent comorbidities. Combination therapy (HCQ + steroids) was most commonly prescribed (36%) and associated with higher DAS28 and Russell's scores. A positive correlation was noted between disease activity and periodontal index values. CONCLUSION: Both systemic comorbidities and oral inflammatory burden influence RA severity. Integrating periodontal assessment with systemic disease monitoring enables more precise, personalized therapy selection. Russell's Index, in conjunction with DAS28 and CRP, may serve as a useful adjunctive marker for therapeutic stratification in RA.