RESEARCH - Anti-TNF-alpha immunotherapy is associated with increased gingival inflammation without clinical attachment loss in subjects with RA

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J Periodontol. 2008 Sep;79(9):1645-51.

Anti-TNF-alpha immunotherapy is associated with increased gingival

inflammation without clinical attachment loss in subjects with

rheumatoid arthritis.

Pers JO, Saraux A, Pierre R, Youinou P.

Department of Dentistry, Brest University Medical and Dental School,

Brest, France.

BACKGROUND: Because periodontitis presents many similarities with

rheumatoid arthritis (RA) with regard to tumor necrosis factor-alpha

(TNF-alpha)-induced bone resorption, the benefits of TNF-alpha

blockade in RA prompted us to determine its efficacy in treating

coexisting periodontitis.

METHODS: Periodontal status was evaluated in 40 subjects with RA who

were divided into two groups: Group I contained 20 subjects who had

received infliximab every 6 weeks for > or =22 months at the time of

periodontal evaluation. The 20 subjects in group II were evaluated

before their first infusion with infliximab. Nine subjects in group II

had periodontitis. These subjects were reevaluated after they received

nine infusions of infliximab.

RESULTS: Infliximab tended to aggravate gingival inflammation as

indicated by differences in the modified gingival and papillary

bleeding indices between subjects in groups I and II with coexisting

periodontitis before and after treatment. Methotrexate had no effect

on periodontal status. Although the plaque index revealed that

bacterial infection persisted, the probing depth was equal in groups I

and II and equivalent before and after treatment in subjects with

periodontitis, whereas attachment loss was decreased after infliximab

treatment.

CONCLUSIONS: Inflammation and destruction constitute two interrelated

yet separate components of periodontitis in patients with RA.

Therefore, TNF-alpha blockade could be beneficial in the treatment of

periodontitis.

PMID: 18771364

http://www.ncbi.nlm.nih.gov/pubmed/18771364

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