Table 2.
Studies assessing the effect of TNF inhibitors on periodontal parameters.
| Authors | TNF inhibitor | Subjects | Assessment | PI | GI | BOP | PPD | CAL |
|---|---|---|---|---|---|---|---|---|
| Varied, no baseline | ||||||||
| Mayer et al. (24) | IFX | RA+ (n = 10) compared to RA without anti-TNF-α (n = 10) | 1 moment (1 calibrated examiner) | NS p > 0.05 | ↓ (sig.) p = 0.0042 | ↓ (sig.) p = 0.0146 | NS p = 0.0554 | ↓ (sig.) p = 0.0273 |
| RA+ (n = 10) compared to healthy patients (n = 10) | 1 moment(1 calibrated examiner) | NS p > 0.05 | NSp > 0.05 | ↓ (sig.) p = 0.0146 | NS p = 0.0554 | ↓ (sig.) p = 0.0273 | ||
| Mayer et al. (25) | IFX | RA+ (n = 12) compared to AI (RA, PA and SSc) (n = 36) | 1 moment(2 calibrated examiners) | NS p = 0.0548 | ↓ (sig.) p = 0.0005 | ↓ (sig.) p = 0.0002 | ↓ (sig.) p = 0.0001 | – |
| RA+ (n = 12) compared to healthy patients (with PD, no AI’s or anti-TNF-α) (n = 12) | 1 moment(2 calibrated examiners) | NS p > 0.05 | NSp > 0.05 | NSp > 0.05 | NS p > 0.05 | – | ||
| Schiefelbein et al. (26) | ETN (n = 2)ADA (n = 5)Golimumab (n = 6) | RA with PD on anti-TNF-α for >12 months (n = 13) versus non RA with PD (n = 13) | 1 moment(1 calibrated examiner) | NSp = 0.182 | – | ↓ (sig.)p = 0.045 | ↓ (NS)p = 0.068 | NSp = 0.134 |
| 30 days follow up | ||||||||
| Üstün et al. (27) | IFX (n = 9)ADA (n = 7) | RA patients with PD (n = 10) | BL + after 30 days(1 examiner) | NS p = 0.779 | ↑(sig.) p = 0.016 | NS p = 0.067 | NS p = 0.413 | NSp = 0.326 |
| 6 weeks follow up | ||||||||
| Ortiz et al. (28) | IFXETNADA | RA patients on PDT and anti-TNF-α (n = 10) | BL + after 6 weeks(1 calibrated examiner) | ↓ (sig.)p < 0.01 | ↓ (sig.)p < 0.01 | ↓ (sig.)p < 0.01 | ↓ (sig.)p < 0.01 | ↓ (sig.)p < 0.05 |
| RA patients on anti-TNF-α (n = 10) | BL + after 6 weeks(1 calibrated examiner) | NSp > 0.05 | NSp > 0.05 | NSp > 0.05 | NSp > 0.05 | NSp > 0.05 | ||
| Anti TNF (n = 10) versus no anti-TNF-α (n = 10) | BL + after 6 weeks(1 calibrated examiner) | NS p = 0.37 | ↓ (sig.) p < 0.001 | ↓ (sig.) p < 0.001 | NS p = 0.107 | ↓ (sig.) p < 0.001 | ||
| Kadkhoda et al. (29) | ETN (n = 36) | RA patients (n = 36) | BL + after 6 weeks | NS *p = 0.860 | ↓(sig.)p = 0.036 | ↓(sig.) p = 0.049 | NS p = 0.126 | – |
| 3 months follow up | ||||||||
| Kobayashi et al. (30) | ADA (n = 20) | Patients with RA (n = 20) | BL + after 3 months(2 calibrated examiners) | NS p = 0.12 | ↓(sig.) p = 0.002 | ↓(sig.) p = 0.003 | ↓(sig.) p = 0.002 | NSp = 0.42 |
| Kobayashi et al. (31) | IFX (n = 6)ETN (n = 9)ADA(n = 19)Golimumab (n = 6) | RA patients treatment with anti-TNF-α (n = 40) | BL + after 3 months(1 examiner calibrated + masked) | NS | ↓(sig.) p < 0.017 | ↓(sig.) p < 0.017 | ↓(sig.) p < 0.017 | NS |
| 6 months follow up | ||||||||
| Kobayashi et al. (31) | IFX (n = 6)ETN (n = 9)ADA(n = 19)Golimumab(n = 6) | RA patients treatment with anti-TNF-α (n = 40) | BL + after 6 months(1 examiner calibrated + blinded) | NS | ↓(sig.) p < 0.017 | ↓(sig.) p < 0.017 | ↓(sig.) p < 0.017 | NS |
| Savioli et al. (32) | IFX (n = 15)ETN (n = 2)ADA (n = 1) | RA patients with PD (n = 8) | BL + after 6 months(1 blinded examiner) | ↓(sig.) p = 0.03 | – | NS p = 0.50 | NS p = 0.25 | NSp = 0.84 |
| RA patients without PD (n = 10) | BL + after 6 months(1 blinded examiner) | NSp = 0.27 | – | NSp = 0.95 | NS p = 0.36 | NSp = 0.91 | ||
| Fabri et al. (33) | IFXETNADA | AS patients and PD (n = 7) | BL + after 6 months(1 blinded examiner) | NS p = 0.21 | – | NS §p = 0.25 | ↓(sig.) p = 0.01 | ↓(sig.) p = 0.04 |
| Patients with RA and PD (n = 7) | BL and + 6 months(1 blinded examiner) | NS p = 0.076 | – | NS §p = 0.118 | NS p = 0.381 | NSp = 0.36 | ||
| Ancuta et al. (34) | IFX, ETN and ADA | RA patients (n = 96) | BL and after 6 months | NS p > 0.05 | NSp > 0.05 | ↓(sig.) p < 0.05 | ↓(sig.) p < 0.05 | ↓(sig.) p < 0.05 |
| Iordache et al. (35) | IFX, ETN, ADA andGolimumab | AS patients (n = 86) | BL and after 6 months | NS p > 0.05 | NSp > 0.05 | ↓(sig.) p < 0.05 | ↓(sig.) p < 0.05 | ↓(sig.) p < 0.05 |
| 9 months follow up | ||||||||
| Pers et al. (36) | IFX (n = 20) | RA patients with PD (n = 9) | BL + after 9 months(1 blinded examiner) | NS p > 0.05 | ↑(sig.) † p < 0.05 | ↑(sig.) ‡p < 0.05 | NS p > 0.05 | ↓(sig.)p < 0.05 |
RA, rheumatoid arthritis patients; RA+, rheumatoid arthritis with anti-TNF-α therapy; AI, Autoimmune disease; PA, psoriatic arthritis; SSc, systemic sclerosis; AS, ankylosing spondylitis; PD, periodontitis; PDT, periodontal treatment; GI, gingival index; PI, plaque index; BOP, bleeding on probing; PPD, probing pocket depth; CAL, clinical attachment level; IFX, infliximab, ETN, etanercept; ADA, adalimumab; BL, baseline, n, number; sig., statistically significant; NS, not statistically significant, *Oral hygiene index (OHI), §Gingival bleeding index (GBI), †Modified gingival index (MGI), ‡Papillary bleeding index (PBI).
Green: significant improvement, Red: significant worsening.