Contribution of individual drugs to gingival overgrowth in adult and juvenile renal transplant patients treated with multiple therapy
. Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug‐induced gingival overgrowth (DIGO). The aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19–84 years) and 60 juveniles (3–18 year...
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| Published in | Journal of clinical periodontology Vol. 25; no. 6; pp. 457 - 464 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.06.1998
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| Subjects | |
| Online Access | Get full text |
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| Abstract | . Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug‐induced gingival overgrowth (DIGO). The aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19–84 years) and 60 juveniles (3–18 years) were scored for DIGO and other clinical variables. Duration of treatment, dosage of drugs per kg body weight and serum cyclosporin levels were recorded. 44% of adults and 27% of children had DIGO. All patients were receiving prednisolone. More adults than children were administered cyclosporin, the reverse was true of azathioprine (P0.01), Explanatory models were evaluated by stepwise ordinal polynomial logistic regression. Statistically significant explanation (P0.05) of DIGO was afforded by prednisolone, nifedipine and azathioprine concentrations in adults and by cyclosporin, nifedipine and azathioprine concentrations in juveniles. Prednisolone and azathioprine were inversely related to the degree of DIGO. Plaque and irregularity scores, lip coverage and mouthbreathing status showed significant additional explanation in adults, replacing nifedipine and azathioprine in the final model. Irregularity was additionally explanatory in children, but no other clinical variables. A larger proportion of the variance of DIGO was explained by the available variables in children than in adults (pseudo r2=0.50 versus 0.25). The degree of DIGO in renal transplant patients is influenced by the dosage of a number of individual components of multiple drug therapy independently of the presence of local clinical factors. |
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| AbstractList | Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug‐induced gingival overgrowth (DIGO). The aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19–84 years) and 60 juveniles (3–18 years) were scored for DIGO and other clinical variables. Duration of treatment, dosage of drugs per kg body weight and serum cyclosporin levels were recorded. 44% of adults and 27% of children had DIGO. All patients were receiving prednisolone. More adults than children were administered cyclosporin, the reverse was true of azathioprine (
P
0.01), Explanatory models were evaluated by stepwise ordinal polynomial logistic regression. Statistically significant explanation (
P
0.05) of DIGO was afforded by prednisolone, nifedipine and azathioprine concentrations in adults and by cyclosporin, nifedipine and azathioprine concentrations in juveniles. Prednisolone and azathioprine were
inversely
related to the degree of DIGO. Plaque and irregularity scores, lip coverage and mouthbreathing status showed significant additional explanation in adults, replacing nifedipine and azathioprine in the final model. Irregularity was additionally explanatory in children, but no other clinical variables. A larger proportion of the variance of DIGO was explained by the available variables in children than in adults (pseudo
r
2
=0.50 versus 0.25). The degree of DIGO in renal transplant patients is influenced by the dosage of a number of individual components of multiple drug therapy independently of the presence of local clinical factors. Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug-induced gingival overgrowth (DIGO). The aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19-84 years) and 60 juveniles (3-18 years) were scored for DIGO and other clinical variables. Duration of treatment, dosage of drugs per kg body weight and serum cyclosporin levels were recorded. 44% of adults and 27% of children had DIGO. All patients were receiving prednisolone. More adults than children were administered cyclosporin, the reverse was true of azathioprine (p<0.01). Explanatory models were evaluated by stepwise ordinal polynomial logistic regression. Statistically significant explanation (p<0.05) of DIGO was afforded by prednisolone, nifedipine and azathioprine concentrations in adults and by cyclosporin, nifedipine and azathioprine concentrations in juveniles. Prednisolone and azathioprine were inversely related to the degree of DIGO. Plaque and irregularity scores, lip coverage and mouthbreathing status showed significant additional explanation in adults, replacing nifedipine and azathioprine in the final model. Irregularity was additionally explanatory in children, but no other clinical variables. A larger proportion of the variance of DIGO was explained by the available variables in children than in adults (pseudo r2=0.50 versus 0.25). The degree of DIGO in renal transplant patients is influenced by the dosage of a number of individual components of multiple drug therapy independently of the presence of local clinical factors. . Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug‐induced gingival overgrowth (DIGO). The aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19–84 years) and 60 juveniles (3–18 years) were scored for DIGO and other clinical variables. Duration of treatment, dosage of drugs per kg body weight and serum cyclosporin levels were recorded. 44% of adults and 27% of children had DIGO. All patients were receiving prednisolone. More adults than children were administered cyclosporin, the reverse was true of azathioprine (P0.01), Explanatory models were evaluated by stepwise ordinal polynomial logistic regression. Statistically significant explanation (P0.05) of DIGO was afforded by prednisolone, nifedipine and azathioprine concentrations in adults and by cyclosporin, nifedipine and azathioprine concentrations in juveniles. Prednisolone and azathioprine were inversely related to the degree of DIGO. Plaque and irregularity scores, lip coverage and mouthbreathing status showed significant additional explanation in adults, replacing nifedipine and azathioprine in the final model. Irregularity was additionally explanatory in children, but no other clinical variables. A larger proportion of the variance of DIGO was explained by the available variables in children than in adults (pseudo r2=0.50 versus 0.25). The degree of DIGO in renal transplant patients is influenced by the dosage of a number of individual components of multiple drug therapy independently of the presence of local clinical factors. |
| Author | Wilson, R. F. Ogg, C. S. Morel, A. Rigden, S. P. A. Ashley, F. P. Koffman, C. G. Smith, D. |
| Author_xml | – sequence: 1 givenname: R. F. surname: Wilson fullname: Wilson, R. F. organization: Department of Dental Clinical Research, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London, England – sequence: 2 givenname: A. surname: Morel fullname: Morel, A. organization: Department of Periodontology and Preventive Dentistry, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London, England – sequence: 3 givenname: D. surname: Smith fullname: Smith, D. organization: Department of Periodontology and Preventive Dentistry, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London, England – sequence: 4 givenname: C. G. surname: Koffman fullname: Koffman, C. G. organization: Department of Nephrology and Transplantation, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London, England – sequence: 5 givenname: C. S. surname: Ogg fullname: Ogg, C. S. organization: Department of Nephrology and Transplantation, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London, England – sequence: 6 givenname: S. P. A. surname: Rigden fullname: Rigden, S. P. A. organization: Paediatric Nephrology, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London, England – sequence: 7 givenname: F. P. surname: Ashley fullname: Ashley, F. P. organization: Department of Periodontology and Preventive Dentistry, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London, England |
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Journal of Periodontology 57, 294-299. 1987; 58 23 1993; 8 1987; 14 1991; 2 1991; 18 1987; 320 1986; 57 1993; 20 1991; 170 1983; 10 1992; 19 1995 1994; 65 1994; 21 1983; 55 1987; 295 1994; 8 1989; 56 1986; 62 1984; 157 1981; 395 1991; 20 1984; 55 1991; 62 1984 1994; 57 1978; 49 1988; 64 1996; 23 1989; 17 1989; 18 Lundergan W. P. (e_1_2_1_16_1) 1989; 17 e_1_2_1_20_1 Montebugnoli L. (e_1_2_1_19_1); 23 e_1_2_1_23_1 Ross P. J. (e_1_2_1_24_1) 1989; 56 Pernu H. E. (e_1_2_1_22_1) 1993; 8 e_1_2_1_21_1 Menard S. W (e_1_2_1_18_1) 1995 e_1_2_1_27_1 e_1_2_1_28_1 e_1_2_1_25_1 e_1_2_1_26_1 e_1_2_1_29_1 Seymour R. A. (e_1_2_1_31_1) 1994; 21 e_1_2_1_7_1 e_1_2_1_8_1 e_1_2_1_30_1 e_1_2_1_5_1 e_1_2_1_6_1 e_1_2_1_3_1 e_1_2_1_12_1 e_1_2_1_35_1 e_1_2_1_4_1 e_1_2_1_13_1 e_1_2_1_34_1 e_1_2_1_10_1 e_1_2_1_33_1 e_1_2_1_2_1 e_1_2_1_11_1 e_1_2_1_32_1 e_1_2_1_39_1 e_1_2_1_17_1 e_1_2_1_38_1 e_1_2_1_14_1 e_1_2_1_37_1 e_1_2_1_15_1 e_1_2_1_36_1 e_1_2_1_9_1 |
| References_xml | – volume: 62 start-page: 30 year: 1991 end-page: 35 article-title: Nifedipin‐induced gingival hyperplasia: a clinical and in vitro study publication-title: Journal of Periodontology – volume: 62 start-page: 417 year: 1986 end-page: 421 article-title: Clinical and pharmacologic correlations in cyclosporine‐induced gingival hyperplasia publication-title: Oral Surgery, Oral Medicine, Oral Pathology – volume: 55 start-page: 708 year: 1984 end-page: 712 article-title: Cyclosporine therapy. 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| Snippet | . Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug‐induced gingival overgrowth (DIGO). The aim of this... Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug-induced gingival overgrowth (DIGO). The aim of this study... Drug regimens for transplantation often consist of multiple therapeutic agents and may result in drug‐induced gingival overgrowth (DIGO). The aim of this study... |
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| SubjectTerms | Adolescent Adult Age Factors Aged Aged, 80 and over Analysis of Variance azathioprine Azathioprine - administration & dosage Azathioprine - adverse effects Body Weight Calcium Channel Blockers - administration & dosage Calcium Channel Blockers - adverse effects Child Child, Preschool Cyclosporine - administration & dosage Cyclosporine - adverse effects Cyclosporine - blood cyclosporins Dental Plaque - complications Drug Combinations Female gingival overgrowth Gingival Overgrowth - chemically induced Glucocorticoids - administration & dosage Glucocorticoids - adverse effects Humans Immunosuppressive Agents - administration & dosage Immunosuppressive Agents - adverse effects Immunosuppressive Agents - blood kidney Kidney Transplantation - adverse effects Lip - physiopathology Logistic Models Male Middle Aged Mouth Breathing - complications Mouth Breathing - physiopathology nifedipine Nifedipine - administration & dosage Nifedipine - adverse effects prednisolone Prednisolone - administration & dosage Prednisolone - adverse effects Time Factors transplantation |
| Title | Contribution of individual drugs to gingival overgrowth in adult and juvenile renal transplant patients treated with multiple therapy |
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