Gingival overgrowth in cyclosporine A treated multiple sclerosis patients

Correlations have been reported between cyclosporine A (CsA)-induced gingival overgrowth (OG) and plaque-induced gingivitis, duration of CsA therapy, and blood and tissue drug levels. We evaluated the relative importance of such factors using data from a 2-year, double-blind study of CsA therapy in multiple sclerosis (MS) patients. Ninety subjects (40 taking CsA; 50 placebo) were evaluated for plaque, calculus, gingivitis, probing depths, attachment levels, and CsA levels in blood and saliva. OG was determined by a panel of 11 calibrated examiners from standardized clinical photographs taken at the end of the study. Logistic regression was used to determine which factors were associated with occurrence of OG. Four (17%) out of 23 CsA patients with CsA trough blood levels < 400 ng/ml exhibited OG. In contrast, 10 (59%) out of 17 CsA patients with CsA trough blood levels > or = 400 ng/ml were affected with OG. Logistic regression analysis resulted in odds ratios of 0.74 (P = 0.009), 17.3 (P = 0.024) and 10.1 (P = 0.030) for the associations between OG and age, CsA trough blood levels > or = 400 ng/ml, and the interaction "color x tone," respectively. In conclusion, the incidence of CsA induced OG appears to be higher with CsA trough blood levels greater than 400 ng/ml.