CONTRIBUTION OF INDIVIDUAL-DRUGS TO GINGIVAL OVERGROWTH IN ADULT AND JUVENILE RENAL-TRANSPLANT PATIENTS TREATED WITH MULTIPLE THERAPY

Drug regimens for transplantation often consist of multiple therapeuti c agents and may result in drug-induced gingival overgrowth (DIGO). Th e aim of this study was to investigate the contribution of individual drugs in renal transplant patients. 147 adults (19-84 years) and 60 ju veniles (3-18 years) were scored for DIGO and other clinical variables . Duration of treatment, dosage of drugs per kg body weight and serum cyclosporin levels were recorded. 44% of adults and 27% of children ha d DIGO. All patients were receiving prednisolone. More adults than chi ldren were administered cyclosporin, the reverse was true of azathiopr ine (p<0.01). Explanatory models were evaluated by stepwise ordinal po lynomial logistic regression. Statistically significant explanation (p <0.05) of DIGO was afforded by prednisolone, nifedipine and azathiopri ne concentrations in adults and by cyclosporin, nifedipine and azathio prine concentrations in juveniles. Prednisolone and azathioprine were inversely related to the degree of DIGO. Plaque and irregularity score s, lip coverage and mouthbreathing status showed significant additiona l explanation in adults, replacing nifedipine and azathioprine in the final model. Irregularity was additionally explanatory in children, bu t no other clinical variables. A larger proportion of the variance of DIGO was explained by the available variables in children than in adul ts (pseudo r(2)=0.50 versus 0.25). The degree of DIGO in renal transpl ant patients is influenced by the dosage of a number of individual com ponents of multiple drug therapy independently of the presence of loca l clinical factors.