Is oral azithromycin effective for the treatment of cyclosporine-induced gingival hyperplasia in cardiac transplant recipients?

Strachan, David P.; Burton, Inari S.; Pearson, Glen J.

doi:10.1046/j.1365-2710.2003.00494.x

Cited by 23 publications

(16 citation statements)

References 14 publications

(74 reference statements)

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“…Reported cases of gingival enlargements were induced by different drugs; CCBs (50/119 – of which amlodipine-25;[8910111213141516171819202122232425262728] nifedipine-13;[26293031323334353637383940] verapamil-4;[41] felodipine-2;[4243] nisoldipine-1;[44] manidipine-1;[45] and unspecified CCBs-4[46]); phenytoin (11/119);[4748495051525354555657] cyclosporine (31/119);[3546585960616263646566676869707172737475] phenobarbital (4/119);[767778] sodium valproate (3/119 - including one report of congenital drug-induced gingival hyperplasia);[798081] d-penicillamine (2/119);[82] combination oral contraceptive pill-lynestrenol and ethinyl estradiol (1/119);[83] vigabatrin (1/119). [84] Cases of gingival enlargement after combination drug therapy have also been reported; a combination of cyclosporine and CCBs (11/119);[354685...…”

Section: Resultsmentioning

confidence: 99%

“…[35606164656667686970727475] It has also been used for treating aplastic anemia,[586073] psoriasis,[62] and Behcet disease. [71] Cyclosporine is known to alter the metabolism of gingival fibroblasts and also upregulates specific growth factors such as platelet-derived growth factor B, thereby causing adverse gingival changes such as overgrowth.…”

Section: Discussionmentioning

confidence: 99%

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Drug-induced gingival overgrowth: A critical insight into case reports from over two decades

Samudrala

Chava

Chandana

et al. 2016

J Indian Soc Periodontol

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Drug-induced gingival overgrowth (DIGO) is a well-recognized adverse effect of certain systemic medications. Calcium channel blockers, anticonvulsants, and immunosuppressants are frequently implicated drugs in the etiology of DIGO. Drug variables, plaque-induced inflammation, and genetic factors are the three important factors in the expression of gingival changes after systemic medication use. Careful clinical examination and thorough history taking form the basis for diagnosis of DIGO. Histopathological examination is often neglected; however, it is an important aid that helps in differential diagnosis. Cessation or change of drug and meticulous plaque control often leads to regression of the lesion, which however might need surgical correction for optimal maintenance of gingival health. The purpose of the present article is to review case reports and case series published in the last two decades and to assimilate and compile the information for clinical applications such as diagnosis and therapeutic management of DIGO.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Drug-induced gingival overgrowth: A critical insight into case reports from over two decades

Samudrala

Chava

Chandana

et al. 2016

J Indian Soc Periodontol

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“…Similar observations were made by various researchers in their respective studies on CsA-induced GO in animal models[1027] and in humans. [8911262829]…”

Section: Discussionmentioning

confidence: 99%

“…In the previous studies, administration of Azi resulted in significant regression or inhibition of CsA-induced GO in renal[892628] and cardiac transplant[29] patients, but effect on CsA + Nf induced GO was not evaluated profundity in dental literature. The present study demonstrates that short-term (7 days) course of Azi can effectively inhibit the GO induced by CsA + Nf combination, along with the simultaneous use of the drugs.…”

Section: Discussionmentioning

confidence: 99%

Effect of azithromycin on gingival overgrowth induced by cyclosporine A + nifedipine combination therapy: A morphometric analysis in rats

Ratre¹,

Mehta

2016

J Indian Soc Periodontol

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Background:Drug-induced gingival overgrowth (DIGO) is a well-known adverse effect of cyclosporine A (CsA) and nifedipine (Nf) therapy. The aim of the present morphometric study was to evaluate the effect of azithromycin (Azi) on the combined GO in rats induced by CsA + Nf combination.Materials and Methods:Thirty Sprague-Dawley male rats were randomly divided equally into three groups. Group 1 (control) received olive oil only; Group 2 received a combination of CsA and Nf in olive oil throughout the study period; Group 3 received CsA + Nf combination therapy, and Azi was added for 1 week in the 5th week. All the drugs were delivered by oral route. Impressions of the mandibular central incisal regions were taken, and study models were prepared at baseline and biweekly up to the 8 weeks. Statistical analysis was done by one-way analysis of variance and intergroup comparisons were made using Tukey's post hoc analysis.Results:Significant GO was evident in Group 2 and Group 3 rats when compared to Group 1. However, in Group 3 (Azi), GO was observed up to the 4th week, but a significant decrease in GO was noticed during 6–8th week after the administration of Azi in 5th week.Conclusion:Azi is an effective drug in the remission of DIGO induced by combined therapy of CsA + Nf and thereby can be considered as a useful therapeutic regimen in minimizing the DIGO in transplant patients.

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“…A study of clinical trials revealed benefits of systemic azithromycin in such conditions [41] Hooda and Narula [13] gave azithromycin to their patients with gingival hyperplasia and symptomatic relief was noticed in all patients. They proposed that treatment with azithromycin is inexpensive and effective in short period of time, avoiding gingival surgery in large number of patients.…”

Section: Drug Therapymentioning

confidence: 99%

Prevalence and clinical aspects of drug-induced gingival enlargement

Ahmed¹,

Bey²,

Hashmi³

et al. 2009

Biomed Res

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Drug-induced gingival enlargement is an iatrogenic condition which is usually not preventable. Certain factors like thorough tooth brushing, proper oral hygiene measures, regular dental flossing and professional care of oral cavity are helpful. Surgical excision of the gingival overgrowth is a treatment of choice but non-surgical methods should be adopted first. More research is needed to investigate measures that can prevent or reduce gingival overgrowth or prevent recurrence. A thorough review of literature reveals that inadequate data exist pertaining to prevalence and treatment options available for iatrogenic gingival hyperplasia. Studies with large number of samples, with statistical analysis, are required to make the data more scientific. Preventive measures have limited value and require regular assessment of patients. Hyperplasia does occur after surgical intervention but percentage of recurrence is not available. Hyperplasia can be managed to a certain extent by withdrawing or changing the medication. However, surgical intervention remains the mainstay of treatment. This paper reviews various aspects of prevalence, pathogenesis and treatment options available to manage drug-induced gingival hyperplasia.

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Is oral azithromycin effective for the treatment of cyclosporine-induced gingival hyperplasia in cardiac transplant recipients?

Cited by 23 publications

References 14 publications

Drug-induced gingival overgrowth: A critical insight into case reports from over two decades

Drug-induced gingival overgrowth: A critical insight into case reports from over two decades

Effect of azithromycin on gingival overgrowth induced by cyclosporine A + nifedipine combination therapy: A morphometric analysis in rats

Prevalence and clinical aspects of drug-induced gingival enlargement

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