Clinical effectiveness of a topical IL-1 receptor antagonist (IL-1ra) in the comprehensive treatment of chronic generalized periodontitis

Chronic generalized periodontitis (CGP) is a widespread inflammatory and destructive disease of periodontal tissues that leads to progressive destruction of supporting structures of the teeth and tooth loss. One of the key mediators of the inflammatory response in periodontal tissues is interleukin-1 (IL-1), which plays a significant role in the activation of osteoclastic bone resorption and progression of periodontal inflammation. Aim. To evaluate the efficacy of anakinra (IL-1ra) as part of complex therapy for moderate chronic generalized periodontitis in comparison with standard treatment and therapy using choline salicylate. Materials and methods. The study included 87 patients with moderate chronic generalized periodontitis. Patients were divided into three groups: group I – standard periodontal therapy (n = 34); group II – standard therapy combined with a drug, Anakinra (a recombinant human IL-1ra; n = 31); group III – standard therapy combined with choline salicylate gel (n = 22). The following clinical parameters were evaluated: probing pocket depth (PPD), papillary bleeding index (PBI), hygiene index (HI), Ramfjord index, Miller tooth mobility index, PMA index, and Fuchs index. Examinations were performed before treatment and after 30 and 90 days. Radiological assessment of periodontal bone structures was performed using cone-beam computed tomography (CBCT). Results. All treatment groups demonstrated statistically significant improvement in periodontal clinical indices after therapy. The most pronounced changes were observed in group II with the use of IL-1ra. After 90 days of treatment, PPD decreased from 3.89 ± 0.11 mm to 1.99 ± 0.03 mm, PBI by 30.1 %, HI by 53.5 %, Miller mobility index by 61.5 %, and PMA index by 57.4 %. CBCT analysis demonstrated stabilization of alveolar bone parameters in patients receiving the IL-1 receptor antagonist. Conclusions. The addition of an IL-1 receptor antagonist to the comprehensive treatment of chronic generalized periodontitis is associated with greater improvements in clinical and radiological outcomes compared with standard therapy and the use of choline salicylate.