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| Title |
Subantimicrobial-Dose Doxycycline (SDD) Periodontal Therapy Reduces Serum Biomarkers Of Systemic Inflammation And Can Increase High-Density Lipoprotein |
| Clinical Question |
In post-menopausal women with chronic periodontitis does a systemic dose of Doxycycline in comparison to placebo increase high-density lipoprotein (HDL) levels? |
| Clinical Bottom Line |
In post-menopausal women with chronic periodontitis Subantimicrobial-Dose Doxycycline Periodontal therapy reduces serum biomarkers of systemic inflammation and among women more than five years post-menopausal, the SDD regimen elevated their level of high-density lipoprotein (HDL) cholesterol. (See Comments on the CAT below) |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 21357860 | Payne/2011 | 128 Post-menopausal women | A randomized, double-masked, placebo-controlled clinical trial | | Key results | In comparison to placebo a two year SDD treatment as an adjunct to periodontal maintenance therapy reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (P=.02) and reduced serum matrix metalloproteinases (MMP)-9 (P < .001), with no significant effect on serum lipids. However, among women more than five years post-menopausal, the SDD regimen elevated their level of high-density lipoprotein (HDL) cholesterol with P= .01. | |
| Evidence Search |
Search doxycycline treatmentSearch periodontal therapy |
Comments on
The Evidence |
This study design was a randomized, double-masked, placebo controlled clinical trial for which 128 eligible post-menopausal women were selected and followed-up across a two-year span. The numbers of participants were similar at start and there was at least 80 percent completion rate of the study. There was adequate follow-up and compliance for each group and there was no recall bias or competing interest for the study. |
| Applicability |
We know that there is a correlation between chronic periodontitis and coronary artery disease. We are seeing an increased number of the older population with chronic periodontitis seeking dental care. Dentist can play a role in potentially reducing the risk of coronary artery disease through the management of the patient chronic periodontitis. |
| Specialty/Discipline |
(General Dentistry) (Periodontics) |
| Keywords |
Postmenopausal Menopausal Periodontitis Subantimicrobial doxycyclineC-reactive proteinDoxycyclineInflammationSerum inflammatory biomarkersHigh-density lipoprotein cholesterol
|
| ID# |
856 |
| Date of submission: |
04/28/2011 |
| E-mail |
korous@livemail.uthscsa.edu |
| Author |
Dunia Korous |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Ernest Valdez, DDS |
| Faculty mentor/Co-author e-mail |
VALDEZE@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Debbie Lee (San Antonio, TX) on 10/08/2014
A PubMed search on application of doxycycline in post-menopausal women with chronic periodontitis increasing HDL levels compared to placebo was completed September 2014. A more recent publication was found: Bretz, 2012, PubMed ID: 23253834. This study analyzed data from the same study published in this CAT. The analyzed data from the randomized controlled trial of 113 patients (control n=62; test n=51) found that even though the treatment modality that involved systemic doxycycline lowered systemic inflammation, there was no significant difference in the lipid profiles among the control and the test group. These results differ from those published in the CAT. | |
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