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High-dose atorvastatin may reduce periodontal inflammation
In a new study, high doses of atorvastatin reduced periodontal inflammation in patients with atherosclerosis or associated risk factors.
“Given the concomitant changes observed in periodontal and arterial inflammation, these data raise the possibility that a portion of that beneficial impact of statins on atherosclerosis relate to reductions in extra-arterial inflammation, e.g. periodontitis,” Sharath Subramanian, MD, of Massachusetts General Hospital and Harvard Medical School, and colleagues wrote.
Researchers enrolled 83 adults with atherosclerosis or at risk for atherosclerosis who were not taking high-dose statins in the multicenter, double blind trial. Half were assigned 10 mg atorvastatin (Lipitor, Pfizer) plus 80 mg placebo daily and half were assigned 80 mg atorvastatin plus 10 mg placebo daily.
Periodontal inflammation, the primary outcome, was assessed at baseline, 4 weeks and 12 weeks using fluorodeoxyglucose PET/CT. Seventy-one participants completed the 12-week follow-up, and 59 had usable periodontal images for analysis.
At 12 weeks, the high-dose statin group had a greater reduction in periodontal inflammation, as measured by periodontal fluorodeoxyglucose uptake values, compared with the low-dose statin group (mean change in target-to-background ratios: high-dose statin group, –0.29 ± 0.85; low-dose statin group, 0.13 ± 0.68; P=.04;difference between groups in mean change in target-to-background ratios, –0.43; 95% CI, –0.83 to –0.02).
The treatment effect did not change after adjustment for age and sex (difference in change in target-to-background ratios between groups, –0.45; P=.034), diabetes and smoking (difference in change in target-to-background ratios between groups, –0.43; P=.04), or prior CAD, baseline HDL, baseline LDL and baseline C-reactive protein (difference in change in target-to-background ratios between groups, –0.45; P=.034).
The effect of high-dose atorvastatin was greater in patients with more periodontal inflammation at baseline (difference between groups in mean change in target-to-background ratios, –0.74; 95% CI, –1.29 to –0.19) and severe bone loss at baseline (difference between groups in mean change in target-to-background ratios, –0.61; 95% CI, –1.16 to –0.054).
The researchers also found a correlation between changes in periodontal inflammation and changes in carotid inflammation (R=0.61; P<.001).
Disclosure: The study was funded by Merck. Two researchers are employees of Merck. Several researchers report financial ties with Merck and Roche.