The Influence of Triclosan on Biomarkers of Cardiovascular Risk in Patients in the Cardiovascular and Periodontal Study (CAPS): A Randomized Controlled Trial.
BACKGROUND
Triclosan toothpaste is effective in controlling plaque and gingivitis and slowing progression of periodontitis; however, its influence on inflammatory biomarkers of cardiovascular disease (CVD), as well as on kidney and liver function, is unknown.


METHODS
Patients recruited from the Cardiovascular Unit at Prince Charles Hospital, Brisbane, Australia, were randomized to triclosan (n = 193) or placebo (n = 190) groups and assessed for total cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, C-reactive protein, erythrocyte sedimentation rate (ESR), hemoglobin, total white cell count (WCC), estimated glomerular filtration rate (eGFR), and liver function enzymes, annually for 5 years. A standard mixed model for each marker included group, sex, age, hypertension, diabetes, periodontal status, statin and anti-inflammatory drug use, and smoking as covariates. Changes in eGFR, WCC, and ESR were further analyzed using transition modeling.


RESULTS
Triclosan toothpaste led to a greater decrease in TC (P = 0.03), LDL cholesterol (P = 0.04), and HDL cholesterol (P = 0.05) than placebo toothpaste. ESR increased at a slower rate in the triclosan group (P ≈ 0.06) and was less likely to increase and more likely to improve in males on statins but not anti-inflammatory drugs in the triclosan group versus the placebo group. Markov modeling of the binary response for eGFR (greater than or less than/equal to the baseline median value) showed that patients with diabetes in the placebo group were significantly (P ≈ 0.05) more likely to deteriorate than either patients with diabetes in the triclosan group or patients without diabetes in each group.


CONCLUSIONS
These data suggest that triclosan toothpaste may influence some inflammatory biomarkers of CVD, but not kidney or liver function. However, it is unclear if this influence is clinically significant.
School of Medicine, The University of Queensland, Brisbane, Australia.|Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand.
Mary P
MP
Cullinan
School of Medicine, The University of Queensland, Brisbane, Australia.
Janet E
JE
Palmer
School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia.
Malcolm J
MJ
Faddy
School of Medicine, The University of Queensland, Brisbane, Australia.
Bill
B
Westerman
Metro North Hospital and Health Service, The Prince Charles Hospital, Queensland, Australia.
Anne D
AD
Carle
School of Medicine, The University of Queensland, Brisbane, Australia.
Malcolm J
MJ
West
School of Medicine, The University of Queensland, Brisbane, Australia.|Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand.
Gregory J
GJ
Seymour
D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D048909:Diabetes Complications; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000032:analysis* / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D012907:Smoking; D014100:Toothpastes / Q000627:therapeutic use*; D014260:Triclosan / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006454:Hemoglobins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D010919:Placebos; D014100:Toothpastes; D014280:Triglycerides; D014260:Triclosan; D002097:C-Reactive Protein; D002784:Cholesterol
Biological markers; cardiovascular diseases; glomerular filtration rate; liver function tests; toothpastes; triclosan