Clinical effectiveness of a topical IL-1 receptor antagonist (IL-1ra) in the comprehensive treatment of chronic generalized periodontitis
DOI:
https://doi.org/10.14739/2310-1210.2026.2.354379Keywords:
chronic generalized periodontitis, clinical indices, inflammation, anti-inflammatory cytokines, IL-1 receptor antagonist, maxillofacial region, inflammatory disease, comprehensive treatment, analysisAbstract
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.
References
Hashim NT, Babiker R, Padmanabhan V, Ahmed AT, Chaitanya N, Mohammed R, et al. The Global Burden of Periodontal Disease: A Narrative Review on Unveiling Socioeconomic and Health Challenges. Int J Environ Res Public Health. 2025;22(4):624. doi: https://doi.org/10.3390/ijerph22040624
Gasner NS, Schure RS. Periodontal disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK554590/
Stødle IH, Sen A, Høvik H, Verket A, Koldsland OC. Association between periodontitis stages and self-reported diseases in a Norwegian population: the HUNT study. BMC Oral Health. 2023;23(1):999. doi: https://doi.org/10.1186/s12903-023-03743-z
Manoil D, Parga A, Bostanci N, Belibasakis GN. Microbial diagnostics in periodontal diseases. Periodontol 2000. 2024;95(1):176-93. doi: https://doi.org/10.1111/prd.12571
Villafuerte K, Palucci Vieira LH, Santos KO, Rivero-Contreras E, Lourenço AG, Motta A. Psychological stress reduces the effectiveness of periodontal treatment: a systematic review. J Clin Med. 2025;14(5):1680. doi: https://doi.org/10.3390/jcm14051680
Alotiby A. Immunology of Stress: A Review Article. J Clin Med. 2024;13(21):6394. doi: https://doi.org/10.3390/jcm13216394
Garlanda C, Di Ceglie I, Jaillon S. IL-1 family cytokines in inflammation and immunity. Cell Mol Immunol. 2025;22(11):1345-62. doi: https://doi.org/10.1038/s41423-025-01358-8
Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, et al. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47 Suppl 22(Suppl 22):4-60. doi: https://doi.org/10.1111/jcpe.13290
Scarfe WC, Farman AG. What is cone-beam CT and how does it work? Dent Clin North Am. 2008;52(4):707-30, v. doi: https://doi.org/10.1016/j.cden.2008.05.005
Kineret (anakinra). European Medicines Agency (EMA). 2020 [cited 2026 Mar 9]. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/kineret
U.S. Food and Drug Administration. Kineret (anakinra): BLA 103950. Fda.gov. [cited 2026 Mar 9]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2020/103950Orig1s5189ltr.pdf
Dahms K, Mikolajewska A, Ansems K, Metzendorf M-I, Benstoem C, Stegemann M. Anakinra for the treatment of COVID-19 patients: a systematic review and meta-analysis. Eur J Med Res. 2023;28(1):100. doi: https://doi.org/10.1186/s40001-023-01072-z
Ostrovska HY, Rozkolupa NV, Petrova TA, Deviatkina NM, Chechotina SY, Vlasova OV. Terapevtychna efektyvnist topichnoho preparatu u farmakoterapii herpetychnoho stomatytu. In: Klinichni protokoly ta personalizovana medytsyna: yak znaity zolotu seredynu. Proceedings of the 11th All-Ukrainian scientific-practical conference with the participation of international specialists in clinical pharmacology [Internet]; 2021 Nov 12-13; Vinnytsia, Ukraine; 2021. p. 188-90. Ukrainian. Available from: https://repository.pdmu.edu.ua/handle/123456789/17462
Dhingra K, Vandana KL. Indices for measuring periodontitis: a literature review. Int Dent J. 2011;61(2):76-84. doi: https://doi.org/10.1111/j.1875-595X.2011.00018.x
Al-Hassan S, Kazlak M, Kateeb E. Effectiveness of an interactive school-based oral health educational program on periodontal status among Palestinian adolescents: An intervention study. Children (Basel). 2025;12(10):1302. doi: https://doi.org/10.3390/children12101302
Kheirkhahi M, Mahdi Farshad M, Khorsand A, Reza Shamshiri A, Farshad F. Relationship between periodontal disease with low birth weight: A prospective cohort study (A path analysis). J Oral Res. 2024;13(1):311-20. doi: https://doi.org/10.17126/joralres.2024.028
Kim GY, Kim S, Chang JS, Pyo SW. Advancements in Methods of Classification and Measurement Used to Assess Tooth Mobility: A Narrative Review. J Clin Med. 2023;13(1):142. doi: https://doi.org/10.3390/jcm13010142
West N, Chapple I, Claydon N, D'Aiuto F, Donos N, Ide M, et al. BSP implementation of European S3 - level evidence-based treatment guidelines for stage I-III periodontitis in UK clinical practice. J Dent. 2021;106:103562. doi: https://doi.org/10.1016/j.jdent.2020.103562
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects: Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. doi: https://doi.org/10.1001/jama.2013.281053
Danko E, Pantyo V. [Non-surgical periodontal treatment of generalized periodontitis: a review]. Suchasna stomatolohiia. 2025;(5):9-19. Ukrainian. doi: https://doi.org/10.33295/1992-576X-2025-5-9
O’Donnell R, Holliday R, Jakubovics N, Benfield E. Methods used to deliver adjunctive probiotic treatment during the non-surgical management of periodontitis: A scoping review. J Dent. 2025;155:105623. doi: https://doi.org/10.1016/j.jdent.2025.105623
Isola G, Polizzi A, Santonocito S, Dalessandri D, Migliorati M, Indelicato F. New frontiers on adjuvants drug strategies and treatments in periodontitis. Sci Pharm. 2021;89(4):46. doi : https://doi.org/10.3390/scipharm89040046
Alassy H, Pizarek JA, Kormas I, Pedercini A, Wolff LF. Antimicrobial adjuncts in the management of periodontal and peri-implant diseases and conditions: a narrative review. Front Oral Maxillofac Med. 2021;3:16. doi: https://doi.org/10.21037/fomm-20-84
Kotowska-Rodziewicz A, Zalewska A, Maciejczyk M. A Review of Preclinical and Clinical Studies in Support of the Role of Non-Steroidal Anti-Inflammatory Drugs in Dentistry. Med Sci Monit. 2023;29:e940635. doi: https://doi.org/10.12659/MSM.940635
Steemers E, Talbi W, Hogervorst J, Schoenmaker T, de Vries TJ. IL-1 Receptor Antagonist Anakinra Inhibits the Effect of IL-1β- Mediated Osteoclast Formation by Periodontal Ligament Fibroblasts. Biology (Basel). 2025;14(3):250. doi: https://doi.org/10.3390/biology14030250
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 O. O. Dmytriieva, S. O. Chertov, S. D. Varzhapetian

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 



