Department of Oral Health Sciences, University of Washington, Seattle, WA, 98195, USA.
Overjet Inc, Boston, MA, 02109, USA.
Geroscience. 2024 Oct;46(5):4135-4146. doi: 10.1007/s11357-024-01221-0. Epub 2024 Jun 6.
Rapamycin (sirolimus) is an FDA approved drug with immune modulating properties that is being prescribed off-label in adults as a preventative therapy to maintain healthspan. We recently published one of the first reports on 333 adults with a history of off-label rapamycin use. Along with presenting evidence that rapamycin can be used safely in adults of normal health status, we discovered that about 26% of rapamycin users also reported oral health changes. Given the recent evidence highlighting the potential benefits of rapamycin and its derivatives in enhancing oral health, we conducted a secondary data analysis to profile the oral health of off-label rapamycin users, the true incidence of mouth sores, and present specific case studies of periodontal bone loss quantification using an FDA-approved artificial intelligence platform. Contrary to expected findings and previous literature, dimensions of rapamycin usage (such as length of use, dosage, and interval) were not found to be related to the incidence of mouth ulcers in rapamycin users. Notably, among rapamycin users, the most deleterious forms of ulcers were found to be infrequent and not statistically linked to rapamycin usage, with most rapamycin users having a common transient form of mouth ulcers. Additionally, we describe the general oral health outcomes of off-label rapamycin users and provide recommendations for individuals engaging in off-label rapamycin to be regularly checked by a dentist or an oral health care provider. This report was limited by being a secondary data analysis taken from survey data that focused on a more holistic health model. Future studies will use a focused survey that collects data on more dimensions of oral health outcomes while including questions on oral health for non-rapamycin-using participants.
雷帕霉素（西罗莫司）是一种获得美国食品药品监督管理局批准的具有免疫调节特性的药物，目前被超适应证用于成年人作为预防治疗药物，以维持健康寿命。我们最近发表了首批 333 名超适应证使用雷帕霉素的成年人的报告之一。除了提供证据表明雷帕霉素可以安全用于健康状况正常的成年人外，我们还发现约 26%的雷帕霉素使用者还报告了口腔健康变化。鉴于最近有证据强调雷帕霉素及其衍生物在增强口腔健康方面的潜在益处，我们进行了二次数据分析，以了解超适应证使用雷帕霉素者的口腔健康状况、口腔溃疡的真实发生率，并介绍使用经美国食品药品监督管理局批准的人工智能平台对牙周骨丢失进行定量的具体病例研究。与预期结果和先前的文献相反，雷帕霉素使用的维度（如使用时间、剂量和间隔）与雷帕霉素使用者口腔溃疡的发生率无关。值得注意的是，在雷帕霉素使用者中，最具危害性的溃疡形式并不常见，也与雷帕霉素使用无关，大多数雷帕霉素使用者具有常见的短暂性口腔溃疡。此外，我们描述了超适应证使用雷帕霉素者的一般口腔健康结果，并为超适应证使用雷帕霉素者提供建议，建议他们定期由牙医或口腔保健提供者进行检查。本报告受到限制，因为它是从关注更全面健康模型的调查数据中进行的二次数据分析。未来的研究将使用更聚焦的调查，在收集更多口腔健康结果维度数据的同时，包括非雷帕霉素使用者的口腔健康问题。
