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Type: Artigo de periódico
Title: Randomized Double-blind Clinical Trial Comparing Clobetasol And Dexamethasone For The Topical Treatment Of Symptomatic Oral Chronic Graft-versus-host Disease.
Author: Noce, Cesar W
Gomes, Alessandra
Shcaira, Vanessa
Corrêa, Maria Elvira P
Moreira, Maria Cláudia R
Silva Júnior, Arley
Gonçalves, Lúcio Souza
Garnica, Marcia
Maiolino, Angelo
Torres, Sandra R
Abstract: Patients who undergo allogeneic stem cell transplantation frequently develop an immunologic disease caused by the reactivation of the graft to the host tissues. This disease is called graft-versus-host disease (GVHD) and it is usually a systemic disorder. In a large proportion of cases, oral disorders that are related to a chronic phase of GVHD (cGVHD) occur, and their treatment involves the use of topical immunosuppressive drugs. Several medications have been studied for this purpose, but only a small number of clinical trials have been published. The present study is a randomized, double-blind clinical trial that compares topical clobetasol and dexamethasone for the treatment of symptomatic oral cGVHD. Patients were randomly assigned to treatment with clobetasol propionate .05% or dexamethasone .1 mg/mL for 28 days. In both arms, nystatin 100,000 IU/mL was administered with the corticosteroid. Oral lesions were evaluated by the modified oral mucositis rating scale (mOMRS) and symptoms were registered using a visual analogue scale. Thirty-five patients were recruited, and 32 patients were randomized into the study groups: 18 patients (56.3%) to the dexamethasone group and 14 patients (43.8%) to the clobetasol group. The use of clobetasol resulted in a significant reduction in mOMRS total score (P = .04) and in the score for ulcers (P = .03). In both groups, there was significant symptomatic improvement but the response was significantly greater in the clobetasol group (P = .02). In conclusion, clobetasol was significantly more effective than dexamethasone for the amelioration of symptoms and clinical aspects of oral lesions in cGVHD.
Subject: Allogeneic Stem Cell Transplantation
Clinical Trial
Graft-versus-host Disease
Oral Disease
Topical Treatment
Citation: Biology Of Blood And Marrow Transplantation : Journal Of The American Society For Blood And Marrow Transplantation. v. 20, n. 8, p. 1163-8, 2014-Aug.
Rights: fechado
Identifier DOI: 10.1016/j.bbmt.2014.04.009
Date Issue: 2014
Appears in Collections:Unicamp - Artigos e Outros Documentos

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