Ying-Chen Chi1,2, Jiunn-Liang Chen3,4,5, Li-Hsuan Wang6, Koyin Chang1, Chen-Long Wu7,8, Shu-Yi Lin2, Joseph Jordan Keller9,10, Chyi-Huey Bai11,12. 1. Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan. 2. Department of Education & Research, Taipei City Hospital, Taipei City, Taiwan. 3. Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 4. Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan. 5. Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan. 6. School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan. 7. Department of Pediatrics, Landseed Hospital, Taoyuan, Taiwan. 8. Department of Pediatrics, Landseed Hospital, Shanghai, China. 9. School of Public Health, College of Medicine, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St, Taipei, 110, Taiwan. Joseph.Jordan.Keller@gmail.com. 10. International Master's Program, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan. Joseph.Jordan.Keller@gmail.com. 11. International Master's Program, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan. 12. Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Abstract
BACKGROUND: Periodontitis is a frequently cited extraintestinal manifestation of Crohn's disease (CD). Despite a plethora of investigations and a recent meta-analysis linking CD and periodontitis, no study has estimated the risk of periodontitis among CD patients with respect to a comparison group nor has any investigation analyzed the effect of CD-specific medications on the risk of periodontitis. The present cohort study compared CD patients and matched subjects without a history of inflammatory bowel disease (IBD) to estimate the effect of CD and CD-specific pharmaceutical prescriptions on the risk of developing periodontitis by leveraging a population-based dataset in Taiwan. METHODS: We sourced 6657 CD patients and 26,628 comparison subjects without a history of IBD from the Taiwan National Health Insurance Database. Cox proportional hazards regressions were used to estimate the risk of subsequent periodontitis by CD status and pharmaceutical prescription during the follow-up period. RESULTS: After adjusting for socioeconomic status (SES), urbanicity, selected medical co-morbidities, and CD-specific pharmaceutical prescriptions, the hazard ratio (HR) for subsequent periodontitis among patients with CD was 1.36 (95% CI = 1.25-1.48) that of comparison subjects. There was not a significant difference in risk between genders or across ages. Steroids (95% CI = 0.66-0.77) appeared to confer a protective effect and Aspirin, Plavix, and Licodin were marginally protective (95% CI = 0.76-0.95). CONCLUSION: This is the first study to report an increased HR for subsequent periodontitis among CD patients when compared to matched comparison subjects without IBD. The protective effect of some pharmaceuticals may suggest that treatment of CD protects against periodontitis.
BACKGROUND:Periodontitis is a frequently cited extraintestinal manifestation of Crohn's disease (CD). Despite a plethora of investigations and a recent meta-analysis linking CD and periodontitis, no study has estimated the risk of periodontitis among CDpatients with respect to a comparison group nor has any investigation analyzed the effect of CD-specific medications on the risk of periodontitis. The present cohort study compared CDpatients and matched subjects without a history of inflammatory bowel disease (IBD) to estimate the effect of CD and CD-specific pharmaceutical prescriptions on the risk of developing periodontitis by leveraging a population-based dataset in Taiwan. METHODS: We sourced 6657 CDpatients and 26,628 comparison subjects without a history of IBD from the Taiwan National Health Insurance Database. Cox proportional hazards regressions were used to estimate the risk of subsequent periodontitis by CD status and pharmaceutical prescription during the follow-up period. RESULTS: After adjusting for socioeconomic status (SES), urbanicity, selected medical co-morbidities, and CD-specific pharmaceutical prescriptions, the hazard ratio (HR) for subsequent periodontitis among patients with CD was 1.36 (95% CI = 1.25-1.48) that of comparison subjects. There was not a significant difference in risk between genders or across ages. Steroids (95% CI = 0.66-0.77) appeared to confer a protective effect and Aspirin, Plavix, and Licodin were marginally protective (95% CI = 0.76-0.95). CONCLUSION: This is the first study to report an increased HR for subsequent periodontitis among CDpatients when compared to matched comparison subjects without IBD. The protective effect of some pharmaceuticals may suggest that treatment of CD protects against periodontitis.
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