Orofacial adverse effects of biological agents

Georgakopoulou, Eleni A.; Scully, Crispian

doi:10.1111/jicd.12102

Cited by 10 publications

(5 citation statements)

References 89 publications

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“…In addition, the fact that etanercept was combined with methotrexate, another agent linked to NHL risk [especially those related to Epstein–Barr virus] enhances the possibility that her NHL is rather related to her long term immunosuppressive therapy rather than her disease ( 7 ). To our knowledge this is among the first [if not the first] reported cases of O-NHL possibly related to etanercept or other anti-TNF agent ( 11 ). Patients with autoimmune diseases and long term immunosuppression should be informed to report their medical history to their dentist and the dentist should check their mouth for any unusual lumps or ulcers, as the clinical appearance of O-NHLs is highly atypical ( 6 ).…”

Section: Discussionmentioning

confidence: 93%

Oral non-Hodgkin’s lymphoma in a patient with rheumatoid arthritis treated with etanercept and methotrexate

Georgakopoulou¹,

Achtari²,

Evangelou³

et al. 2015

J Clin Exp Dent

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Oral non-Hodgkin’s lymphomas (O-NHLs) are a rare group of diverse lymphoid tissue malignancies and represent less than 5% of the oral cavity malignancies and 2% of all extra-nodal NHLs. Oral-NHLs affect the Waldeyer’s-ring, the salivary glands, the bone of the jaws and the oral mucosa, their clinical appearance is very heterogeneous. Among the risk factors for NHLs are immunosuppression (primary or secondary), autoimmunity and inflammation. O-NHLs share the same risk factors. This case report describes a patient with O-NHL which was possibly linked to the combination of methotrexate and etanercept for the treatment of her rheumatoid arthritis. To our knowledge this is probably among the first cases of O-NHL with possible relation to the use of a Tumor Necrosis Factor (TNF) antagonist biological agent (etanercept). This case could contribute to the sensitization of the dentists for the signs and symptoms of this rare malignancy. It also underlines the need for thorough medical history and medication recording for all the dental patients. Key words:Lymphoma (oral) methotrexate, etanercept.

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Section: Discussionmentioning

confidence: 93%

Oral non-Hodgkin’s lymphoma in a patient with rheumatoid arthritis treated with etanercept and methotrexate

Georgakopoulou¹,

Achtari²,

Evangelou³

et al. 2015

J Clin Exp Dent

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“…With regard to the use of biologicals, whose use is quite common in immunocompromised patients, it is advisable to discuss with the treating physician whether the administration of the biological has to be modified or specific precautions have to be taken. Biologicals can be accompanied by a variety of oral side effects (Georgakopoulou & Scully, ,b).…”

Section: Immunocompromised Patientsmentioning

confidence: 99%

“…A variety of drugs can have oral manifestations as a side effect or side effects which have to be considered when placing dental implants. Many of these side effects are comprehensively summarized by Scully and co‐authors (Georgakopoulou & Scully, ,b; Scully & Bagan, ). The side effects of chemotherapy, anticoagulants, antiresorptive drugs, and biologics have already addressed.…”

Section: Drugsmentioning

confidence: 99%

“…Driven by his great interest in and knowledge of diseases with dental and medical involvement, the late Crispian Scully has written numerous papers on phenomena that can be present in medically compromised patients and their treatment (Georgakopoulou & Scully, ,b; Jin et al., ), on the side effects of drugs (Georgakopoulou & Scully, ,b; Scully & Bagan, ) as well as the impact of these phenomena on implant survival and peri‐implant health (Diz, Scully, & Sanz, ). Particularly, the paper of Diz et al.…”

Section: Introductionmentioning

confidence: 99%

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The medically compromised patient: Are dental implants a feasible option?

2018

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In healthy subjects, dental implants have evolved to be a common therapy to solve problems related to stability and retention of dentures as well as to replace failing teeth. Although dental implants are applied in medically compromised patients, it is often not well known whether this therapy is also feasible in these patients, whether the risk of implant failure and developing peri-implantitis is increased, and what specific preventive measures, if any, have to be taken when applying dental implants in these patients. Generally speaking, as was the conclusion by the leading review of Diz, Scully, and Sanz on placement of dental implants in medically compromised patients (J Dent, 41, 2013, 195), in a few disorders implant survival may be lower, and the risk of a compromised peri-implant health and its related complications be greater, but the degree of systemic disease control outweighs the nature of the disorder rather than the risk accompanying dental implant treatment. So, as dental implant treatment is accompanied by significant functional benefits and improved oral health-related quality of life, dental implant therapy is a feasible treatment in almost any medically compromised patient when the required preventive measures are taken and follow-up care is at a high level.

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“…Both the clinician and the oral pathologist should be familiar with oral lesions that may develop during treatment with DMARDs (disease modifying anti‐rheumatic drugs), particularly methotrexate, anti‐resorptive drugs to treat osteoporosis, multiple myeloma and metastatic malignancies, and targeted molecular therapies for malignant disease (Kalantzis, Marshman, Falconer, Morgan, & Odell, ; Li et al., ; Yarom, Elad, Madrid, & Migliorati, ). There is clearly a need to keep up with emerging information on diseases and their treatment, from authoritative and reliable sources that should include textbooks supplemented with current reviews, focus publications, and position papers (Georgakopoulou & Scully, ; Ruggiero et al., ).…”

Section: Overviewmentioning

confidence: 99%