Background: Recent studies indicated that rheumatic disorder can be associated with olfactory loss.
Objectives: To specifically investigate chemosensory function in patients with rheumatoid arthritis (RA) by valid and reliable psychophysical tests and compare them to healthy controls.
Methods: We investigated 212 RA patents (43 men, 169 women; mean age 59 years) and compared their results to 30 healthy controls (10 men, 20 women; mean age 40 years). All participants received standardized olfactory (odor thresholds, odor discrimination and identification for suprathreshold testing) and gustatory tests (taste sprays – suprathreshold taste function; taste strips – quasi-threshold gustatory test). In addition, blood chemistry was also assessed (e.g., for CRP, RA factors, and anti-CCP).
Results: RA patients rated their senses of smell and taste to be as good as that of controls. However, in RA patients 4% were found to be anosmic, and 36% to be hyposmic. These numbers were 0 and 20%, respectively, in controls. RA patients exhibited significantly lower scores in odor identification and discrimination. Gustatory test scores were also decreased in RA patients. No such differences were found for odor thresholds. Interestingly, the changes in olfactory and gustatory function neither correlated with disease duration nor with indicators of RA activity or severity like C-reactive protein, rheumatoid factors, anti-CCP antibodies orDAS28-Score. Moreover, there was no correlation between olfactory dysfunction and treatment with DMARDs, e.g. amount of MTX, or Tumor necrosis factor α inhibitors.
Conclusion: These results indicate that olfactory and gustatory function is significantly decreased in patients with RA. This decrease in function seems to be unnoticed by most patients which may be due to the fact that RA patients have no compete loss of function (anosmia), but still function in the range of hyposmia or even normosmia. Importantly, the changes in olfactory function are not observed at the level of odor thresholds but only for suprathreshsold tasks, which may suggest that the decrease in function is due to higher-order central-nervous processing of olfactory information. In addition, the lack of correlations between disease parameters and chemosensory dysfunction indicates that the decrease in chemosensory function may be a trait characteristic of RA patients.
Disclosure of Interests: Joerg Wendler Consultant for: Chugai, Roche, AbbVie, Novartis, Janssen-Cilag, Speakers bureau: Chugai, Roche, AbbVie, Novartis, Janssen-Cilag, Khang Tran: None declared, Martin Aringer Grant/research support from: Roche, Consultant for: AstraZeneca and Eli Lilly, Florian Schuch Consultant for: Celgene, Lilly, UCB, Roche, Sanofi-Aventis, Abbvie, Novartis, Speakers bureau: Celgene, Lilly, UCB, Roche, Sanofi-Aventis, Abbvie, Stefan Kleinert Grant/research support from: Novartis, Consultant for: Novartis, UCB, Chugai, Celgene, Medac, Roche, Abbvie, Speakers bureau: Novartis, UCB, Chugai, Celgene, Medac, Roche, Abbvie, Antje Haehner: None declared, Thomas Hummel: None declared
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