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J Periodontal Res:抗风湿药对类风湿性关节炎和牙周炎患者牙周状况的影响

2021-11-30 MedSci原创 MedSci原创

近年来,类风湿性关节炎(RA)与牙周炎的相关性已成为研究热点,但目前尚无针对RA和牙周炎患者的用药建议。近日,发表于J Periodontal Res的一项系统综述评价了各种抗风湿药物对牙周状况的影响

近年来,类风湿性关节炎(RA)与牙周炎的相关性已成为研究热点,但目前尚无针对RA和牙周炎患者的用药建议。近日,发表于J Periodontal Res的一项系统综述评价了各种抗风湿药物对牙周状况的影响,旨在为类风湿性关节炎(RA)和牙周炎患者提供临床用药指导。

研究人员检索了截至2021年3月20日数据库内收录的相关文章。研究的纳入标准如下:纳入被诊断为牙周炎和RA的患者,接受抗风湿剂治疗;对照组不接受抗风湿剂治疗;结果包括至少一个牙周参数。采用加权平均差异(WMD)和95%置信区间(CI)汇总探诊深度(PD)和临床附着丧失(CAL),采用标准化平均差异(SMD)和95%CI进行分析牙龈指数(GI)/改良牙龈指数(MGI)。

研究人员筛选了可能与本综述目的相关的1478项研究,但只有14项研究的463名患者被纳入定性分析,4项研究的146名患者被纳入meta分析。分析结果显示,在接受抗风湿药治疗PD的受试者中观察到统计学上的显著减少[WMD=-0.20;95%CI(-0.33,-0.07);效应P=.003;I2=50%;P=. 11],CAL[WMD=-0.4;95%CI(-0.66,-0.15);效应p=.002;I2=57%;p=.07]和GI/MGI[SMD=-0.61;95%CI(-0.94,-0.27;效应p=.0004;I2=26%;p=.25]。

与上述结果一致,该系统综述得出有利的结果,即当RA和牙周炎患者接受传统的合成改变病情的抗风湿药物(csDMARDs)、抗B淋巴细胞药物、抗IL-6R药物或JAK抑制剂治疗时,PD、CAL、GI/MGI和探诊出血(BOP)都会减少。在使用抗TNF-α药物后,PD和CAL下降;大多数研究报告GI/MGI和BOP下降,而2项研究报告GI/MGI和BOP上升。

综上所述,这些结果显示,csDMARDs、抗B淋巴细胞制剂、抗IL-6R制剂、抗TNF-α制剂和JAK抑制剂对改善RA和牙周炎患者的牙周状况有潜在的积极作用。然而,未来的研究需要阐明抗TNF-α制剂是否有增加牙龈炎症的副作用。

 

原始出处:

Jiamin Zhang, et al., Influence of anti-rheumatic agents on the periodontal condition of patients with rheumatoid arthritis and periodontitis: A systematic review and meta-analysis. J Periodontal Res. 2021 Dec;56(6):1099-1115. doi: 10.1111/jre.12925.  

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    2021-12-09 feather89
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    2021-12-01 lmm397
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    2021-11-30 ms4000000749026929

    学习了,真好

    0

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