PPI Use and Periodontal Disease: What’s the Link? – MPR – Monthly Prescribing Reference

The use of proton pump inhibitors (PPIs) in patients with generalized, chronic, moderate-to-severe periodontitis (stage III to IV; grade B to C) was associated with less severe periodontitis, according to study findings presented at the 2019 AIBD Annual Meeting in Orlando, Florida.

For this study, researchers aimed to assess whether treatment with a PPI could potentially decrease bone loss in patients with periodontitis. Data from patients who were referred to the postgraduate periodontics program at the University at Buffalo between 2010 and 2017 was used to identify those with generalized, chronic, moderate-to-severe periodontitis (N=518). The significance of systemic factors such as inflammatory bowel disease (IBD), smoking, diabetes, hypothyroidism, and other autoimmune disorders, in addition to medication history (ie, systemic steroids, hormone replacement therapy), were taken into account in the final analysis. The severity of periodontitis was measured by calculating the percentage of teeth that had pocket depths of 6mm.

We found that there was an inverse relationship between use of PPI and severity of [periodontitis], independent of the systemic conditions noted above, the authors reported. Findings from the study showed that 13.1% of patients on PPIs had pocket depths 6mm compared with 19.9% of those not receiving PPIs, resulting in a 34.2% decrease in severity (95% CI 2.1%, 11.6%; P =.006). Similar results were observed in the unadjusted patient population (15.7% on PPI vs 22.6% not on PPI; P=.004).

The data indicate that more conservative periodontal therapy might initially be considered for IBD patients with advanced periodontal disease for whom PPI are prescribed as a component of their IBD treatment, the authors concluded.

Reference

Yerke LM, Cohen RE; Relationship Between Proton Pump Inhibitors and Periodontal Disease: Treatment Considerations for IBD Patients. Presented at the 2019 AIBD Annual Meeting on December 12-14 2019 in Orlando, FL.

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PPI Use and Periodontal Disease: What's the Link? - MPR - Monthly Prescribing Reference