Efficacy of Rebamipide as Adjunctive Therapy in the Treatment of Recurrent Oral Aphthous Ulcers in Patients with Beh??et??s Disease

Abstract

Rebamipide is well tolerated and improves the aphthae count and pain score in BD patients. It may therefore be useful in the treatment and prevention of frequently recurrent oral aphthous ulcers (not restricted to BD). Administration of rebamipide is not cumbersome, and it does not cause any discomfort, which corticosteroid ointments for example may do; furthermore, there are no specific adverse drug reactions. Rebamipide is therefore recommended as a long-term treatment for recurrent oral aphthous ulcers.

Efficacy of Rebamipide and Levamisole in the Treatment of Patients with Recurrent Aphthous Ulcer - A Comparative Study

“…In an epidemiological survey it was concluded that minor aphthous ulcer is the most common type of RAS and constitutes about 80%. Major aphthous ulcer is about 13% and herpetic form 7% in accordance with the present study [11]. In a study it was documented that minor aphthous ulcer constitutes 75-85% of total RAS cases whereas major aphthous ulcer is about 10-15% and herpetiform type is the smallest group with only 5% [13].…”

“…In another study prevalence of RAS was seen in patients below the age of 10 y, whereas no patients were reported below the age of 10 years in the present study [12]. In another study it was documented that in about 80% of patients with RAS the condition develops before 30 y of age and the onset in later years suggests a possibility of definite predisposing factor leading to RAS or that ulceration is not simple RAS, but rather a part of more complex disorder such as Behcet's disease [11].…”

“…Another study revealed RAS with predilection for females in age group of 10-15 y, at the onset of puberty or after 50 y of age, hormonal changes after menopause being the reason for increased occurrence of RAS in females. RAS most frequently occurs in females as systemic factor associated with RAS like haematinic deficiencies are more common in females of older age group [11], but the present study comprised of majority of patients in younger age group. Another study for decreased incidence of RAS among males states that smoking had inverse relationship with the occurrence of RAS as it causes keratinization and renders the mucosa less susceptible to ulceration [12].…”

“…It acts by the decrease in oxygen radicals, increase in blood flow and production of protective prostaglandins in ulcer mucosa, which accelerates the process of healing [9]. The investigators assessed the efficacy of rebamipide in patients with Behcet's disease whose main symptom was oral aphthosis [10,11].…”

“…Least common site of occurrence was alveolar mucosa, tongue, gingival and soft palate, constituting only about 7%. According to a study, ulcers are confined to the non-keratinized mucosa of the mouth regardless of the type of RAS occurring more commonly on buccal mucosa and labial mucosa, followed by maxillary and mandibular sulci, non-attached gingiva, and floor of the mouth, ventral surface of the tongue, soft palate and tonsillar fauces [11]. RAS spares the dorsum of the tongue, attached gingiva and hard palatal mucosa which are keratinized [10].…”