Long-Term Utilization Patterns of Topical Therapy and Clinical Outcomes of Oral Chronic Graft-versus-Host Disease

Shazib, Muhammad Ali; Muhlbauer, Jillian; Schweiker, Rachel; Li, Shuli; Cutler, Corey; Treister, Nathaniel S.

doi:10.1016/j.bbmt.2019.09.029

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…Patients with symptomatic oral GVHD may need topical treatment for two years or longer, steroid therapies and tacrolimus are safe and effective in this management, however second line treatments for refractory oral GVHD require further investigation. 28 , 29 , 30 …”

Section: Review/resultsmentioning

confidence: 99%

Dentistry consensus on HSCT – Part III: Special topics – Dentistry on HSCT

Santos,

Granzotto,

Antunes

et al. 2023

Hematology, Transfusion and Cell Therapy

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Section: Review/resultsmentioning

confidence: 99%

Dentistry consensus on HSCT – Part III: Special topics – Dentistry on HSCT

Santos,

Granzotto,

Antunes

et al. 2023

Hematology, Transfusion and Cell Therapy

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“…However, 723 articles were excluded because they did not fulfil all eligibility criteria. Therefore, 10 articles resulted as eligible, but 7 were excluded because they were prospective [ 18 , 19 , 20 , 21 ] or retrospective [ 22 , 23 , 24 ] studies. In the end, three RCTs were included [ 25 , 26 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

Topical Corticosteroids a Viable Solution for Oral Graft versus Host Disease? A Systematic Insight on Randomized Clinical Trials

et al. 2020

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Background and Objectives: This research attempts to provide a clear view of the literature on randomized clinical trials (RCTs) concerning the efficacy of topical dexamethasone, clobetasol and budesonide in oral graft versus host disease (GVHD). Materials and Methods: An electronic search of the PubMed, Web of Science and Scopus databases was carried out for eligible RCTs. Studies were included if they had adult patients with oral GVHD treatment with topical corticosteroids, and if the RCT study was published in English. The Cochrane Risk of Bias tool was used to assess the quality of these studies. Overall, three RCTs were included (an Open, Randomized, Multicenter Trial; a Randomized Double-Blind Clinical Trial; and an Open-Label Phase II Randomized Trial). Results: The trials involved 76 patients, of which 44 patients received topical dexamethasone, 14 patients received topical clobetasol and 18 patients received topical budesonide. Topical agents were most frequently used when oral tissues were the sole site of involvement. It appears that the best overall response is present for budesonide with no difference between the four arms, followed by clobetasol, and then by dexamethasone. The limitation of the current study is mainly represented by the fact that overall response was derived in two of the studies from other parameters. Moreover, both budesonide and clobetasol were used in only one study each, while two assessed dexamethasone. Conclusions: Based on the clinical trials, all three agents seem to be effective in treating oral GVHD and had a satisfactory safety profile. There is still a need for assessing high quality RCTs to assess the efficacy of these therapies on a larger cohort.

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“…These results are similar to those of Shazib MA et al . in 2020, who reported that there was an overall reduction in the median oral mucosal score from 3 at the 1-month follow-up to 1 at the 24-month follow-up for all evaluated subjects ( 2 ). We also found that the organ-specific severity scores were significantly reduced between FU0 and FU4, and FU0 and FU5.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic graft-versus-host-disease (cGVHD) is a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT), affecting up to 70% of recipients and commonly involve the skin, mouth, eyes, gastrointestinal tract, liver, lungs, and joints ( 1 , 2 ). The clinical features of cGVHD resemble several autoimmune or immune-mediated conditions, such as systemic lupus erythematosus, scleroderma, and lichen planus that are characterized by fibrosis and chronic inflammation ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic response of oral chronic graft-versus-host disease to topical corticosteroids according to the 2014 National Institutes of Health (USA) consensus criteria

Siripornkitti,

Pengpis,

Chanswangphuwana

et al. 2024

Med Oral

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Background Chronic graft-versus-host-disease (cGVHD) is a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. The oral cavity is one of the most frequently affected anatomic sites and is affected in 70% of all patients who develop cGVHD. The objective of this study was to determine the therapeutic response to topical corticosteroids and clinical outcome of patients with oral cGVHD using the 2014 NIH consensus criteria. Material and Methods The oral manifestations of cGVHD were collected at the first and the follow-up (FU) visits after the therapeutic treatment of oral GVHD. The FU intervals were: FU0, first visit; FU1, 0-1 month; FU2, 1-3 months; FU3, 3-6 months; FU4, 6-9 months; and FU5, 9-12 months. The oral cGVHD activity was assessed using the NIH modification of the Schubert Oral Mucosa Rating Scale (OMRS) and Thongprasom sign score. The functional impact was assessed by the organ-specific severity score. Results Fourteen patients (93.3%) at FU0 were being treated with at least one form of systemic immunosuppressive therapy, i.e., prednisolone, cyclosporin, and tacrolimus. The OMRS was reduced between FU0 and FU3 ( p < 0.001), FU0 and FU4 ( p < 0.001), and FU0 and FU5 ( p = 0.004). The organ-specific severity scores were also reduced between FU0 and FU4 ( p = 0.016), and FU0 and FU5 ( p = 0.001). There was no significant difference in the highest Thongprasom sign score between all follow-up intervals (FU0-FU5) ( p = 0.201). One patient (6.7%) at FU4 and three patients (20.0%) at FU5 did not receive topical corticosteroid therapy for oral cGVHD. Conclusions The oral cGVHD lesions and functional impacts improved within 6 months and 9 months, respectively. However, most of the patients required topical corticosteroid therapy for more than 1 year to control their symptoms and lesions. Key words: Oral chronic graft-versus-host disease, 2014 National Institutes of Health consensus criteria, Hematopoietic cell transplantation, therapeutic response, topical corticosteroid.

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Long-Term Utilization Patterns of Topical Therapy and Clinical Outcomes of Oral Chronic Graft-versus-Host Disease

Cited by 5 publications

References 26 publications

Dentistry consensus on HSCT – Part III: Special topics – Dentistry on HSCT

Dentistry consensus on HSCT – Part III: Special topics – Dentistry on HSCT

Topical Corticosteroids a Viable Solution for Oral Graft versus Host Disease? A Systematic Insight on Randomized Clinical Trials

Therapeutic response of oral chronic graft-versus-host disease to topical corticosteroids according to the 2014 National Institutes of Health (USA) consensus criteria

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