Oral Candidiasis in Patients with Rheumatoid Arthritis: A Hospital-Based Cohort Study

Abstract

Background: Rheumatoid (RA) arthritis is a chronic autoimmune disease characterized by symmetric polyarthritis and systemic inflammation. Systemic complications due to RA and its treatment may affect oral health. Objective: To assess the prevalence and predisposing factors for oral candidiasis in Rheumatoid Arthritis patients treated at a rheumatology referral hospital. Methods: This is a longitudinal study of a panel of repeated measures performed on patients attending the Rheumatology and Oral Diagnosis Outpatient Clinic of the General Hospital of Cuiabá. Patients were followed up between 2018 and 2019, with the information recorded in the medical records and subsequently extracted. A generalized estimation equation model was used to assess the association between oral candidiasis and RA. Results: In the final model, in crude (bivariate) analysis, the use of prednisone (OR 8.3) and tocilizumab (OR 3.7) were significantly associated with oral candidiasis. In the multivariate generalized estimation equation model, the use of prednisone (OR 9.9) and the presence of hyposalivation in male patients (OR 1.8) were the variables that remained statistically associated with oral candidiasis. Conclusion: The use of immunosuppressive drugs and the low rate of salivary flow in male patients increase the risk of oral candidiasis in patients with rheumatoid arthritis, reinforcing the importance of stomatological monitoring, a preventive approach and early diagnosis of this pathology.