GINGIVAL OVERGROWTH IN CYCLOSPORINE-A TREATED MULTIPLE-SCLEROSIS PATIENTS

CORRELATIONS HAVE BEEN REPORTED BETWEEN cyclosporine A (CsA)-induced g ingival overgrowth (OG) and plaque-induced gingivitis, duration of CsA therapy, and blood and tissue drug levels. We evaluated the relative importance of such factors using data from a 2-year, double-blind stud y of CsA therapy in multiple sclerosis (MS) patients. Ninety subjects (40 taking CsA; 50 placebo) were evaluated for plaque, calculus, gingi vitis, probing depths, attachment levels, and CsA levels in blood and saliva. OG was determined by a panel of 11 calibrated examiners from s tandardized clinical photographs taken at the end of the study. Logist ic regression was used to determine which factors were associated with occurrence of OG. Four (17%) out of 23 CsA patients with CsA trough b lood levels <400 ng/ml exhibited OG. In contrast, 10 (59%) out of 17 C sA patients with CsA trough blood levels greater than or equal to 400 ng/ml were affected with OG. Logistic regression analysis resulted in odds ratios of 0.74 (P = 0.009), 17.3 (P = 0.024) and 10.1 (P 0.030) f or the associations between OG and age, CsA trough blood levels greate r than or equal to 400 ng/ml, and the interaction ''color X tone,'' re spectively. In conclusion, the incidence of CsA induced OG appears to be higher with CsA trough blood levels greater than 400 ng/ml.