Treatment of cyclosporin-induced gingival hyperplasia with azithromycin.

Abstract

BACKGROUND:

Gingival hyperplasia is a known complication of cyclosporin therapy. Although plaque control has been shown to be of benefit, gingival surgery is occasionally necessary. The aim of this study was to review the effect of a short-course therapy with azithromycin in renal transplant patients with cyclosporin-induced gingival hyperplasia.

METHODS:

Thirty-eight patients received 500 mg/day of azithromycin for 3 consecutive days. The degree of gingival hyperplasia was classified as: 0, no gingival overgrowth; 1, mild overgrowth; 2, moderate overgrowth, and 3, severe overgrowth. Gingival bleeding and evolution of gingival hyperplasia were determined at 0 (pretreatment), 7, 30, 90 and 180 days. Cyclosporin, serum creatinine and ALT levels were simultaneously determined on the same days.

RESULTS:

Seven patients were excluded, leaving a total of 31 included in the trial. Eleven had a score of 3, 17 a score of 2, and 3 a score of 1. The degree of gingival hyperplasia was unrelated to the dose and levels of cyclosporin. Gingival hyperplasia improved in all patients (P < 0.001, Friedman test). The degree of improvement was better when the degree of hyperplasia was lower. In 27 patients gingival hyperplasia remained absent 6 months later, 3 patients required a second course of treatment, and another required gingival surgery. Gingival bleeding, present in 28 patients when diagnosed, disappeared in all cases in 2.2 +/- 1.2 (1-7) days. No adverse effects were observed. Cyclosporin, serum creatinine, and ALT levels were not affected by treatment.

CONCLUSIONS:

Azithromycin improves cyclosporin-associated gingival hyperplasia, especially when administered early in the process.

• Authors: E Gómez, M Sánchez-Nuñez, J E Sánchez, C Corte, S Aguado, C Portal, J Baltar, J Alvarez-Grande
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 12 Issue 12 Pg. 2694-7 (Dec 1997) ISSN: 0931-0509 [Print] England
• PMID: 9430874 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Immunosuppressive Agents
• Azithromycin
• Cyclosporine

Topics

• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Azithromycin (therapeutic use)
• Cyclosporine (adverse effects, therapeutic use)
• Female
• Gingival Hyperplasia (chemically induced, drug therapy, pathology)
• Humans
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Kidney Transplantation
• Male
• Middle Aged
• Postoperative Care