France Katherine, Yogarajah Sangeetha, Gueiros Luiz Alcino, Valdez Remberto, Mays Jacqueline W, Posey Rachael, Payne Aimee S, Setterfield Jane, Sollecito Thomas P, Woo Sook-Bin, DeRossi Scott, Greenberg Martin S, Carey Barbara
Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA.
Department of Oral Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.
J Oral Pathol Med. 2023 Jan;52(1):1-8. doi: 10.1111/jop.13389. Epub 2022 Dec 13.
Biologic agents are rapidly emerging as an effective therapy to treat autoimmune and other chronic diseases. The use of these agents is poorly characterized, resulting in a lack of guidance for dental practitioners. Case reports of oral adverse events have begun to emerge. However, their scope and frequency have not been summarized and analysed to date. The objective of this review was to characterize the literature on oral adverse effects associated with biological therapy when used for autoimmune and inflammatory disorders.
This review was developed in accordance with scoping review recommendations. Search strategies were developed and employed for six databases. Studies were selected using a systematic search process but with broad inclusion of study types given the paucity of information available. Reports of oral adverse events were analysed descriptively according to agent, mechanism of action, underlying disease, and oral adverse effect observed.
Our search returned 2080 articles and 51 met our inclusion criteria, of which most were case reports. The most frequent adverse effects included angioedema, oral lichenoid lesions, osteonecrosis of the jaw, and oral infections. There were also cases of oral malignancies associated with use of biologic agents. Less common effects such as pigmentation were also described.
Oral adverse events have been reported in patients on biologic therapy, albeit in small numbers to date. This limits the generalizability of these results, which should not be used to generate a clinical guideline as they are based primarily on case reports. However, this study presents the first review characterizing the adverse effects observed. Large multi-center studies will be necessary to further define the oral and dental complications caused by biologic agents.
生物制剂正迅速成为治疗自身免疫性疾病和其他慢性疾病的有效疗法。这些制剂的使用情况目前描述甚少，导致牙科医生缺乏相关指导。口腔不良事件的病例报告已开始出现。然而，迄今为止，其范围和频率尚未得到总结和分析。本综述的目的是描述与生物疗法用于自身免疫性和炎症性疾病相关的口腔不良反应的文献。
本综述是根据范围综述的建议开展的。针对六个数据库制定并采用了检索策略。鉴于可用信息匮乏，采用系统检索过程选择研究，但广泛纳入各种研究类型。根据药物、作用机制、基础疾病以及观察到的口腔不良反应，对口腔不良事件报告进行描述性分析。
我们的检索返回了2080篇文章，51篇符合我们的纳入标准，其中大多数是病例报告。最常见的不良反应包括血管性水肿、口腔苔藓样病变、颌骨坏死和口腔感染。也有使用生物制剂相关的口腔恶性肿瘤病例。还描述了色素沉着等不太常见的影响。
生物疗法患者中已报告了口腔不良事件，尽管迄今为止数量较少。这限制了这些结果的普遍性，由于这些结果主要基于病例报告，因此不应将其用于制定临床指南。然而，本研究首次对观察到的不良反应进行了综述。需要开展大型多中心研究来进一步明确生物制剂引起的口腔和牙科并发症。
