Subantimicrobial dose doxycycline effects on alveolar bone loss in post-menopausal women
Subantimicrobial dose doxycycline effects on alveolar bone loss in post-menopausal women
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DOI：
10.1111/j.1600-051x.2007.01115.x
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发表时间：
2007-09-01
影响因子：
6.7
通讯作者：
Golub, Lorne M.
中科院分区：
文献类型：
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作者：
Payne, Jeffrey B.;Stoner, Julie A.;Golub, Lorne M.
目的：在一项为期2年的双盲、安慰剂对照、随机临床试验中，确定2年连续亚抗菌剂量多西环素（SDD; 20mg bid）对绝经后骨质减少、雌激素缺乏妇女牙周维持的牙槽骨的疗效。材料和方法：128名受试者随机分为SDD组和安慰剂组（n=64）。使用放射吸收仪（RA）和计算机辅助密度图像分析（CADIA），在基线、1年和2年测量牙槽骨密度（ABD）和牙槽骨高度（ABH）。统计分析采用广义估计方程；初步分析为意向治疗（ITT）。结果显示为SDD与安慰剂的对比。结果：ITT下，SDD对ABD损失（RA: p=0.8; CADIA: p=0.2）和ABH损失（p=0.2）均无统计学意义。大部分位点（81 ~ 95%）为非活性位点。在亚组分析中，非吸烟者的平均CADIA高于SDD (p=0.05)，基线探测深度>= 5 mm （p=0.003）。在绝经后50年的女性中，SDD与进一步ABH丧失的几率降低29%相关（p=0.05），与遵循方案的受试者相比，SDD与进一步ABH丧失的几率降低36%相关（p=0.03）。结论：在患有牙周炎的绝经后骨质减少妇女中，SDD总体上与安慰剂没有差异。基于探索性亚组分析，需要进一步的研究来确定SDD在非吸烟者、绝经后50岁和较富裕人群中的有效性。
Aim: Determine the efficacy of 2-year continuous subantimicrobial dose doxycycline (SDD; 20 mg bid) on alveolar bone in post-menopausal osteopenic, oestrogen-deficient women undergoing periodontal maintenance in a 2-year double-blind, placebo-controlled, randomized clinical trial.Material and Methods: One-hundred and twenty-eight subjects randomized to SDD or placebo (n=64 each). Posterior vertical bite wings taken at baseline, 1 and 2 years for alveolar bone density (ABD), using radiographic absorptiometry (RA) and computer-assisted densitometric image analysis (CADIA), and alveolar bone height (ABH). Statistical analyses utilized generalized estimating equations; primary analyses were intent to treat (ITT). Results are presented as SDD versus placebo.Results: Under ITT, there was no statistically significant effect of SDD on ABD loss (RA: p=0.8; CADIA: p=0.2) or ABH loss (p=0.2). Most sites (81-95%) were inactive. For subgroup analyses, mean CADIA was higher with SDD for non-smokers (p=0.05) and baseline probing depths >= 5 mm (p=0.003). SDD was associated with 29% lower odds of more progressive ABH loss in women > 5 years post-menopausal (p=0.05) and 36% lower among protocol-adherent subjects (p=0.03).Conclusions: In post-menopausal osteopenic women with periodontitis, SDD did not differ overall from placebo. Based on exploratory subgroup analyses, additional research is needed to determine the usefulness of SDD in non-smokers, subjects > 5 years post-menopausal and in deeper pockets.