Are statins really wonder drugs?

Statins [3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase], are wonder drugs that have reshaped the treatment of hypercholesterolemia and associated cardiovascular diseases. However, evidence from various studies indicates existence of many statin-induced side effects such as myopathies, rhabdomyolysis, hepatotoxicity, peripheral neuropathy, impaired myocardial contractility, diabetes, autoimmune diseases, and erectile dysfunction (ED). Physician awareness of these side effects is reported to be very low even for the adverse effects (AEs) most widely reported by patients. This can lead to incorrect treatment decisions, compromised patient care, and an increase in patient morbidity. Therefore, the aim of this article is to highlight the AEs of statin therapy as well as rational management of these complications to further improve safety of these excellent drugs.

Teriparatide: a novel means to ultimately achieve true regeneration!!!

"Perioceutics" or the use of the pharmacological agents which are specifically developed to manage periodontitis, is an interesting and an emerging aid in the management of periodontal diseases, along with mechanical debridement. Host modulation therapies are being proposed and developed to bring down excessive levels of enzymes, cytokines, prostanoids, as well modulate osteoclast functions. Over the past two decades, many drugs have been investigated for their host modulating properties in both animal and early human clinical studies. These agents include non-steroidal anti-inflammatory drugs, sub antimicrobial dose doxycycline and systemic bisphosphonates. Recently, a new drug has been added to the list, namely, teriparatide, which is a bone forming drug. It is a biosynthetic human parathyroid hormone. Multiple clinical trials have shown that teriparatide is associated with increased bone mineral density. This review has focused on the mechanism of action of teriparatide and its potential role in the treatment of periodontal disease.

The pleotropic role of statins: Could it be the imminent host modulation agent in periodontics?

Periodontal disease is a chronic inflammatory disease which represents a primarily anaerobic Gram-negative oral infection that results in gingival inflammation, loss of attachment, bone destruction. Bacterial endotoxins in the form of lipopolysaccharides (LPS) that are instrumental in generating a host-mediated tissue destructive immune response by mobilizing their defensive cells and releasing cytokines like Interleukin-1ß (IL-1ß), Tumor Necrosis Factor-α (TNF-α), and Interleukin-6 (IL-6), which lead to tissue destruction by stimulating the production of the collagenolytic enzymes: Matrix metalloproteinases (MMPs). Since the host-mediated tissue destruction is to be controlled, various means have been employed for modulating this response. Statins, 3-hydroxy-3-methylglutarylcoenzyme A (HMG CoA) reductase inhibitors, besides having lipid-lowering abilities also have antioxidant, antithrombotic, anti-inflammatory, immunomodulatory and osteomodulatory properties. All of these pleiotropic effects of statins point out to it perhaps becoming the novel host modulation agent in periodontics.