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Systemic treatment in severe cases of recurrent aphthous stomatitis: an open trial
Maria Angela Martins Mimura1, Silvio Kenji Hirota, Norberto Nobuo Sugaya
1Department of Stomatology, School of Dentistry, University of São Paulo - São Paulo/SP, Brazil.
Purpose:
This study aimed to evaluate the efficacy of the systemic drugs thalidomide, dapsone, colchicine, and pentoxifylline in the treatment of severe manifestations of RAS.
Methods:
An open, 4-year clinical trial was carried out for 21 consecutive patients with severe RAS. Initially, patients were given a 2-week course of prednisone to bring them to a baseline status. Simultaneously, one of the four test drugs was assigned to each patient to be taken for a period of 6 months. During the course of the trial, patients were switched to one of the other three drugs whenever side effects or a lack of satisfactory results occurred, and the 6-month limit of the treatment was then reset.
Results:
The most efficient and best-tolerated drug was thalidomide, which was administered to a total of eight patients and resulted in complete remission in seven (87.5%). Dapsone was prescribed for a total of nine patients, of whom eight (89%) showed improvement in their symptoms, while five showed complete remission. Colchicine was administered to a total of ten patients, with benefits observed in nine (90%), of whom four showed complete remission. Pentoxyfilline was administered to a total of five patients, with benefits observed in three (60%), of whom one patient showed complete remission.
Conclusion:
The therapeutic methods used in this trial provided significant symptom relief. Patients experienced relapses of the lesions; however, this occurred after withdrawal of their medication during the follow-up period.
Insights
Thalidomide, dapsone, and colchicine showed significant efficacy in treating severe recurrent aphthous stomatitis (RAS). Thalidomide was the most effective, with 87.5% complete remission in RAS patients.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Recurrent aphthous stomatitis (RAS) can cause severe oral manifestations.
- Systemic drug therapies are explored for managing severe RAS.
- Limited data exists on comparative efficacy of certain systemic agents.
Purpose of the Study:
- To evaluate the efficacy of thalidomide, dapsone, colchicine, and pentoxifylline for severe RAS.
- To identify the most effective and best-tolerated systemic drug for RAS management.
Main Methods:
- An open, 4-year clinical trial involving 21 patients with severe RAS.
- Initial prednisone treatment followed by 6-month courses of one of four systemic drugs.
- Patients were switched to alternative drugs if side effects or lack of efficacy occurred.
Main Results:
- Thalidomide achieved complete remission in 7 of 8 patients (87.5%).
- Dapsone improved symptoms in 8 of 9 patients (89%), with 5 complete remissions.
- Colchicine benefited 9 of 10 patients (90%), with 4 complete remissions; Pentoxifylline showed lower efficacy.
Conclusions:
- Systemic thalidomide, dapsone, and colchicine offer significant symptom relief for severe RAS.
- Relapses occurred after medication withdrawal during follow-up.
- Thalidomide demonstrated the highest efficacy and best tolerability among the tested drugs.
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