Therapeutic Management of Recurrent Aphthous Stomatitis: A Review of the Growing Knowledge

Sabbagh, Abdulrahman Hani; Felemban, Mutaz Fahad

doi:10.21276/aimdr.2016.2.6.de1

Cited by 4 publications

(2 citation statements)

References 40 publications

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“…There has been armamentarium of systemic drugs available like prednisolone, azathioprine, thalidomide, cyclosporine, methotrexate, dapsone, pentoxifylline and colchicine. 6 Apremilast is the new addition to this spectrum. Till date, there are no studies which conducted a head on comparison between apremilast and other conventional drugs like colchicine and dapsone.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of apremilast versus dapsone versus colchicine in recurrent aphthous stomatitis: a three arm double blinded comparative study

Yadav,

Arora,

Yadav

2024

Int J Res Med Sci

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Background: Recurrent aphthous stomatitis (RAS) is often considered as an incurable ailment. Therefore, an effective management option is required for controlling the symptoms and severity of RAS. We aimed to conduct a study to compare the effectiveness and safety profile of apremilast, dapsone and colchicine in management of RAS. Methods: This three-arm double blinded comparative study included 60 cases of recurrent aphthous stomatitis (RAS). Twenty patients each were randomly allocated in three groups: group A (apremilast), group B (dapsone) and group C (colchicine). Results: At the end of 6 weeks, the complete response was seen in 6 (30%) patients in group A as compared to 2 (10%) and 4 (20%) patients in group B and C (p >0.05). At the end of 12 weeks, response rate became statistically significant (p=0.003) with complete response in 14 (70%) of patients. Median time to recurrence, defined as oral ulcer after loss of complete response, was significantly increased to 4.3 weeks in group A as compared to group B and C. The most commonly encountered side effects were gastrointestinal in all three groups. None of the adverse effects resulted in discontinuation of treatment, hospitalization or death in any patient. Conclusions: Although, traditional therapies like dapsone and colchicine have been commonly used in clinical practice, apremilast yielded a rapid and maintained improvement of RAS.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of apremilast versus dapsone versus colchicine in recurrent aphthous stomatitis: a three arm double blinded comparative study

Yadav,

Arora,

Yadav

2024

Int J Res Med Sci

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“…In many patients, resolution of the systemic disorder gives rise to a reduced incidence and severity of the mucosal ulcerations. 2,3 The mucosal destruction in RAS patients appears to represent a T cellmediated immunologic reaction with production of tumor necrosis factor-alpha. However, the initiating causes are variable.…”

mentioning

confidence: 99%

Appraising the Clinical Efficacy of Herbal Topical Medications in the Treatment of Recurrent Aphthous Stomatitis - A Review

Muthu¹,

Saravanan²,

Rethinam³

et al. 2021

JYP

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In recent times, consciousness towards the utilization of bio friendly and eco-friendly plant based products for the prevention and remedy of various human illnesses has paid considerable attention. The faith towards the herbal medicines has been growing worldwide. The phytochemical found in plants have protective and disease preventive properties which are non-nutritive in nature. 1 Recurrent Aphthous Stomatitis (RAS) is considered as a mucosal disease which occurs locally and not a result of systemic disease. Since there is any definitive recommended treatment protocol for aphthous ulcer, patients are advised to attempt various medications, particularly in recurrent cases of aphthous ulcer. Many herbs which have potential for symptomatic treatment of aphthous are lacking scientific evidence for clinical use. Though many potential herbs were identified through ethno biological survey, the therapeutic isolation and clinical application of the herbal components are still lacking. Few herbs were tried on animal models and lab studies on human cells. The recurrent ulcers appear periodically and heal completely between attacks. These ulcers have comparatively few common reasons. The common recurrent oral ulcers include recurrent aphthous ulcer (RAU), erythema multiforme, occasional traumatic ulcers and ulcers associated with gastro intestinal diseases. 2 RAU otherwise referred to as the common canker sore is a painful ulcerative lesion of an uncertain etiology. These recurring ulcers are T cell mediated solitary or multiple lesions, frequently seen in childhood and adolescent females.Nutritional deficiencies, inflammatory bowel diseases, celiac disease, Behcet's syndrome, HIV are few conditions associated with aphthous stomatitis. The clinical forms include recurrent aphthous minor, recurrent aphthous major and recurrent herpetiform ulcerations. The minor ulcers commonly involve non keratinized mucosa with ulcers ranging from 3-10 mm diameter and resolve within 1-2 weeks. The major ulcers usually appear on the detached buccal and labial mucosa with more than 1 centimeter in diameter and heal in six weeks' time. However, it has been suggested that these ulcers respond poorly to any kind of therapies. In many patients, resolution of the systemic disorder gives rise to a reduced incidence and severity of the mucosal ulcerations. 2,3 The mucosal destruction in RAS patients appears to represent a T cellmediated immunologic reaction with production of tumor necrosis factor-alpha. However, the initiating causes are variable. It has been theorized that aphthous ulcerations develop from an immunologic response to an oral antigen. This reaction may arise due to the presence of a highly antigenic reagent, a decrease in the mucosal barrier that previously masked the antigen, or immune dysregulation resulting in an abnormal response to a normally present antigen. The genetic factors, oral microbial flora and immunological factors plays major role in the etiology of RAS. Though there is multifactorial etiology, trauma, stress, all...

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Long-term Stabilization of Aqueous Doxycycline Formulations, in Mucoadhesive Hydrogels for Treatment of Oral Mucosal Conditions

Patlolla

Holbrook

Gizurarson

et al. 2020

CDDT

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Background: The main aim of this work was to develop stable (>2 years) doxycycline formulation, at clinically relevant concentrations and using clinically relevant formulation. Doxycycline has a MMP- inhibitory effects that is important for the treatment of various oral mucosal conditions. Therefore, protecting doxycycline from degradation in aqueous formulation requires halting or prevention of oxidation and epimerisation of the active compound. Methods: Stabilizing excipients were intuitively put together to enhance the stability as a cumulative effort. A total of 30 hydrogels were compared with different types and concentrations of stability enhancing excipients, pH, storage temperatures (4, 25 and 40°C) and mucoadhesive polymers. The duration of the study was from day 1 and up to 58 months. The gelation temperature was adjusted below the actual body temperature. The complexation efficiency between the doxycycline and HPβCD was studied using the DSC, FTIR and XRPD. Results: The majority of formulations at 4°C were highly stable by the end of 58 months and their stabilities were improved at all 3 temperatures. Conclusion: In conclusion, it is possible to prevent doxycycline from both oxidation and epimerization in an aqueous formulation, for up to 5 years.

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Therapeutic Management of Recurrent Aphthous Stomatitis: A Review of the Growing Knowledge

Cited by 4 publications

References 40 publications

Efficacy and safety of apremilast versus dapsone versus colchicine in recurrent aphthous stomatitis: a three arm double blinded comparative study

Efficacy and safety of apremilast versus dapsone versus colchicine in recurrent aphthous stomatitis: a three arm double blinded comparative study

Appraising the Clinical Efficacy of Herbal Topical Medications in the Treatment of Recurrent Aphthous Stomatitis - A Review

Long-term Stabilization of Aqueous Doxycycline Formulations, in Mucoadhesive Hydrogels for Treatment of Oral Mucosal Conditions

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