Background: The treatment of leprosy reactions (LRs) involves thalidomide, corticosteroids, and other immunomodulatory medications. This study evaluated the effect of these treatments on the association between periodontitis and LRs, as well as factors associated with LRs.Methods: This case–control study was conducted on 283 individuals followed at a leprosy outpatient clinic in Brazil. The case group was comprised of 158 individuals presenting type 1 or type 2 LRs, and the control group of 125 leprosy individuals without reactions. A complete oral examination was performed to diagnose periodontitis, the independent variable. Antireaction medication used was collected from medical records, and participants were classified according to the use of prednisone and/or thalidomide, time of use, or non‐use of medication. Socioeconomic–demographic, clinical, and lifestyle covariables were collected by interview. Unconditional logistic regression analysis by subgroups evaluated the effect of antireaction medication on the association between periodontitis and LRs, estimating the odds ratio with a 95% confidence interval (OR; 95% CI).Results: A relationship between periodontitis and LRs was observed only in the subgroup using the association prednisone and thalidomide: ORadjusted = 0.32; 95% CI = 0.11–0.95. Conversely, more severe periodontal clinical parameters were observed in cases versus controls. Several socioeconomic, health conditions, and lifestyle factors were associated with the presence of LRs.Conclusions: Although periodontal disease indicators were worse among the cases, the findings showed a negative relationship between periodontitis and LRs in individuals receiving associated prednisone and thalidomide. These medications appear to influence the inflammatory cascade between diseases, modifying and masking the manifestations of periodontitis.

中文翻译：

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抗反应药物对牙周炎和麻风反应之间关系的影响：牙周医学中的一个重要方法学问题


背景：麻风反应（LR）的治疗涉及沙利度胺、皮质类固醇和其他免疫调节药物。本研究评估了这些治疗对牙周炎和 LR 之间关系以及与 LR 相关因素的影响。方法：这项病例对照研究对巴西麻风病门诊的 283 名个体进行了跟踪。病例组由 158 名出现 1 型或 2 型 LR 的个体组成，对照组由 125 名无反应的麻风病个体组成。进行完整的口腔检查以诊断牙周炎（自变量）。使用的抗反应药物是从病历中收集的，参与者根据泼尼松和/或沙利度胺的使用、使用时间或不使用药物进行分类。通过访谈收集社会经济-人口统计、临床和生活方式协变量。按亚组进行的无条件逻辑回归分析评估了抗反应药物对牙周炎和 LRs 之间关联的影响，以 95% 置信区间（OR；95% CI）估计比值比。 结果：仅在使用泼尼松和沙利度胺联合的亚组：或调整过的= 0.32; 95% CI = 0.11–0.95。相反，与对照组相比，病例中观察到更严重的牙周临床参数。一些社会经济、健康状况和生活方式因素与 LRs 的存在相关。结论：尽管病例中牙周疾病指标较差，但研究结果显示，接受相关泼尼松和沙利度胺治疗的个体中，牙周炎与 LRs 之间呈负相关。 这些药物似乎会影响疾病之间的炎症级联反应，改变和掩盖牙周炎的表现。