Efficacy of sub-antimicrobial dose doxycycline in post-menopausal women: clinical outcomes
: Richard A. Reinhardt
: Blackwell Synergy
Aims: To determine the clinical efficacy of a 2-year continuous sub-antimicrobial
dose doxycycline (SDD; 20 mg bid) in post-menopausal, osteopenic, oestrogendeficient
women on periodontal maintenance.
Materials and Methods: One-hundred and twenty-eight subjects were randomized
to SDD (n564) or placebo (n564). Clinical measurements were performed at
posterior interproximal sites at baseline and every 6 months during this 2-year
randomized, double-blind, placebo-controlled clinical trial with adjunctive,
no-cost 3Ã¢â‚¬â€œ4-month periodontal maintenance. Statistical analyses of secondary
outcomes from this clinical trial used Generalized Estimating Equations in
primarily intent-to-treat analyses.
Results: For the placebo group, 3.4% of the sites showed improvement in clinical
attachment levels (CAL) and 2.7% had progressive loss in CAL; for the SDD group,
5.0% of the sites showed an improvement in CAL and 2.2% had progressive loss in
CAL. This difference (2.1% of sites) was more favourable in the SDD group than in
the placebo [odds ratio (OR)50.81%, 95% confidence interval (CI): 0.67Ã¢â‚¬â€œ0.97,
p50.03] in these well-maintained patients, whereas probing depths, bleeding on
probing and supragingival plaque did not differ significantly between groups (p40.2).
However, in exploratory subgroup analysis of non-smokers, SDD showed reduced
bleeding versus placebo (27% versus 33%; p50.05). In protocol-adherent subjects,
the odds of bleeding were 34% lower for SDD (p50.05).
Conclusions: Analyses of secondary outcomes of this clinical trial indicated that SDD
may be of benefit in reducing progressive attachment loss in post-menopausal females;
additional research is needed to confirm these findings.
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