Recurrent aphthous stomatitis: A comprehensive review and recommendations on therapeutic options

Lau, Charles B; Smith, Gideon P.

doi:10.1111/dth.15500

Cited by 44 publications

(36 citation statements)

References 57 publications

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“…This review assessed the effectiveness of 20 different topical treatments in reducing pain by using VAS, a well‐established and highly reliable method for subjective assessment of pain. However, the results showed no superiority of any treatment over placebo concerning pain reduction 26,27 …”

Section: Discussionmentioning

confidence: 96%

“…Patients with RAS may complain of severe chronic pain and distress that can considerably affect their quality of life 25 . Ideally, to choose suitable topical therapy for treating RAS, priority is given to its safety and effectiveness in relieving pain, promoting healing time, reducing the duration of disease and recurrence, and improving patients' quality of life 26,27 . This review assessed the effectiveness of 20 different topical treatments in reducing pain by using VAS, a well‐established and highly reliable method for subjective assessment of pain.…”

Section: Discussionmentioning

confidence: 99%

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Topical medications for the treatment of recurrent aphthous stomatitis: A network meta‐analysis

Mashrah,

Fang,

Song

et al. 2023

J Oral Pathology Medicine

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BackgroundThe present network meta‐analysis aims to answer the question “what is the best topical intervention for the treatment of recurrent aphthous stomatitis that can provide an acceptable pain relief and promote wound healing?”MethodsFrom inception to October 2022, PubMed, Embase, Scopus, Cochrane Library, and China National Knowledge Infrastructure were searched to identify all potentially eligible randomized controlled trials. The primary outcomes were pain scores and/or healing time, while the secondary outcomes were the associated side effects. The Bayesian network meta‐analysis accompanied by a random effect model and 95% credible intervals were calculated.ResultsForty‐three randomized controlled trials with a total of 3067 participants, comparing 20 different topical medications, were included. Concerning pain reduction, the network meta‐analysis failed to show any statistically significant differences when different topical treatments were compared together or even with a placebo at different time intervals. Except for doxycycline, which showed a statistically significant difference in terms of accelerating healing time, other topical interventions showed no statistically significant differences when compared with placebo or with each other.ConclusionWithin the limitations of the current network meta‐analysis, it seems that: A low to moderate quality of evidence showed no superiority of any topical treatment over others concerning pain reduction, although rank probability tests revealed sucralfate, doxycycline, hyaluronic acid, and chamomile as the most efficacious treatment options at different evaluation times. Hence, further well‐designed clinical trials with larger sample sizes are warranted. Topical doxycycline was shown to be the most efficacious intervention in promoting healing of recurrent aphthous stomatitis.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Topical medications for the treatment of recurrent aphthous stomatitis: A network meta‐analysis

Mashrah,

Fang,

Song

et al. 2023

J Oral Pathology Medicine

View full text Add to dashboard Cite

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“…Our study extends to the age-speci c population, which only a few reports have emphasized in RAS research. Although the etiological mechanism of RAS remains unclear, possible triggers are supposed to play a crucial role [2]. Such factors include mechanical injuries, viral and bacterial infections, stress, food allergies, vitamin and microelement de ciencies, genetic predisposition, hormonal level uctuations, increased oxidative stress, and systemic diseases [6].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular diseases, risk factors, and ulcer relapse in older adults with recurrent aphthous stomatitis: A retrospective cohort study

Yao

Deng

et al. 2023

Preprint

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Objectives To test the hypothesis that cardiovascular diseases (CVDs) and risk factors are associated with ulcer relapse in after-retirement patients with recurrent aphthous stomatitis (RAS). Subjects and Methods: This retrospective cohort study analyzed the data of 40 minor RAS patients aged 55–75 years, admitted to Oral Medicine Clinic at one university hospital in China between 2016 and 2018. The diagnosis of minor RAS was made based on the history and manifestation of oral ulcers. The ulcer relapse was evaluated after a 5-week anti-inflammatory treatment, and the history of systemic diseases was collected. CVD/MR referred to the presence of any CVDs and metabolic CVD risks. Associations among CVDs, risk factors, and ulcer relapse were evaluated. Results The mean age of 40 patients with minor RAS was 62.4 years (SD 5.1), and 40% were men. The ulcer relapse rate was 37.5% (95% CI, 0.242–0.530). The proportion of CVD/MR was higher in the relapse group than in the no-relapse group after 5-week anti-inflammatory treatment (Fisher’s exact test, P = 0.041). Conclusions CVD/MR was associated with ulcer relapse after anti-inflammatory treatment. Clinical Relevance: Healthcare providers must counsel patients about CVDs plus metabolic CVD risks and provide timely intervention.

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“…Recurrent aphthous ulcerations is a common chronic disease in the oral mucosa, characterized by solitary or multiple, recurrent, small ulcers with erythematous halos and yellow or gray pseudomembranes ( Lau and Smith, 2022 ). Psoriasis is an immune-mediated genetic skin disease that can also manifest in joints; chronic plague psoriasis represents the majority of cases ( Boehncke and Schön, 2015 ).…”

Section: Phosphodiesterase Inhibitors In Clinics—current Statusmentioning

confidence: 99%

“…Here, PDE inhibitors are considered interesting additions to the established treatment strategies. Amlexanox is a first-line treatment option in apthous stomatitis ( Lau and Smith, 2022 ). Apremilast is active in both psoriatic arthritis and cutaneous manifestations of the disease; however, its overall efficacy is low compared to other available options ( Boehncke and Schön, 2015 ).…”

Section: Phosphodiesterase Inhibitors In Clinics—current Statusmentioning

confidence: 99%

Recent developments of phosphodiesterase inhibitors: Clinical trials, emerging indications and novel molecules

et al. 2022

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The phosphodiesterase (PDE) enzymes, key regulator of the cyclic nucleotide signal transduction system, are long-established as attractive therapeutic targets. During investigation of trends within clinical trials, we have identified a particularly high number of clinical trials involving PDE inhibitors, prompting us to further evaluate the current status of this class of therapeutic agents. In total, we have identified 87 agents with PDE-inhibiting capacity, of which 85 interact with PDE enzymes as primary target. We provide an overview of the clinical drug development with focus on the current clinical uses, novel molecules and indications, highlighting relevant clinical studies. We found that the bulk of current clinical uses for this class of therapeutic agents are chronic obstructive pulmonary disease (COPD), vascular and cardiovascular disorders and inflammatory skin conditions. In COPD, particularly, PDE inhibitors are characterised by the compliance-limiting adverse reactions. We discuss efforts directed to appropriately adjusting the dose regimens and conducting structure-activity relationship studies to determine the effect of structural features on safety profile. The ongoing development predominantly concentrates on central nervous system diseases, such as schizophrenia, Alzheimer’s disease, Parkinson’s disease and fragile X syndrome; notable advancements are being also made in mycobacterial infections, HIV and Duchenne muscular dystrophy. Our analysis predicts the diversification of PDE inhibitors’ will continue to grow thanks to the molecules in preclinical development and the ongoing research involving drugs in clinical development.

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Recurrent aphthous stomatitis: A comprehensive review and recommendations on therapeutic options

Cited by 44 publications

References 57 publications

Topical medications for the treatment of recurrent aphthous stomatitis: A network meta‐analysis

Topical medications for the treatment of recurrent aphthous stomatitis: A network meta‐analysis

Cardiovascular diseases, risk factors, and ulcer relapse in older adults with recurrent aphthous stomatitis: A retrospective cohort study

Recent developments of phosphodiesterase inhibitors: Clinical trials, emerging indications and novel molecules

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