Lúpus eritematoso sistêmico: os impactos da polimedicação na cavidade bucal

Abstract

Systemic Lupus Erythematosus (SLE) is a multisystemic, idiopathic and autoimmune chronic inflammatory disease that can lead to mucocutaneous, rheumatological, neurological and renal involvement. The disordered activity of the immune system exceeds the immunological tolerance and can cause damage to several systems of the human body. Patients with SLE may require multiple medications and the polypharmacy may be associated with oral effects. Objective: To investigate the effects of polypharmacy on the oral health of individuals with SLE. Methodology: Data collected from 46 patients, 17 from the control group and 29 being treated for Systemic Lupus Erythematosus, include: age, race, sex, medications for the treatment of SLE, various medications, indices (gingival, plaque and bleeding to probing), number of teeth with probing greater than 3mm, CPOD, xerostomia and number of missing, decayed and filled teeth. In addition, the total anticholinergic load was calculated for each patient according to the drugs used. Results: The analyzes show that the SLE group has a greater number of patients exposed to polypharmacy (62.1%) and with a sum of anticholinergic load greater than zero (75.9%). It was also possible to observe the existence of significant correlations between the anticholinergic load and xerostomia (r=0.346 - low positive correlation) and with polypharmacy (r=0.557 - moderate positive correlation). Conclusion: Patients in the SLE group are more exposed to polypharmacy and have a higher total anticholinergic burden when compared to others in the same group who do not fit into polypharmacy. The results of this study reiterate the presence of oral involvement in patients conditioned to the treatment of Systemic Lupus Erythematosus and also suggest that there is a need for a new perspective that considers the risks that polypharmacy can generate to general and oral health.