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Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease

BACKGROUND: Oral chronic graft versus host disease (cGVHD) is a major complication in transplantation community, a problem that can be addressed with topical intervention. Topical corticosteroids are the first line of treatment although the choice remains challenging as none of the available treatme...

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Autores principales: Elsaadany, Basma Abdelaleem, Ahmed, Eman Magdy, Aghbary, Sana Maher Hasan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5511636/
https://www.ncbi.nlm.nih.gov/pubmed/28751912
http://dx.doi.org/10.1155/2017/1908768
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author Elsaadany, Basma Abdelaleem
Ahmed, Eman Magdy
Aghbary, Sana Maher Hasan
author_facet Elsaadany, Basma Abdelaleem
Ahmed, Eman Magdy
Aghbary, Sana Maher Hasan
author_sort Elsaadany, Basma Abdelaleem
collection PubMed
description BACKGROUND: Oral chronic graft versus host disease (cGVHD) is a major complication in transplantation community, a problem that can be addressed with topical intervention. Topical corticosteroids are the first line of treatment although the choice remains challenging as none of the available treatments is supported by strong clinical evidence. OBJECTIVE: This systematic review aims to determine the clinical efficacy and safety of topical corticosteroids for the management of the mucosal alterations of oral cGVHD. DATA SOURCES: Electronic search of different databases was conducted: PubMed, Cochrane library, Grey literature, WHO, and clinical trials.gov for clinical trial registration as well as hand search in the references of relevant articles up to November 2016. DATA EXTRACTION: Extracted pieces of information were intervention, population, sample sizes, and outcomes. DATA SYNTHESIS: Six studies were included: 2 randomized clinical trials (RCTs), 3 cohort studies, and 1 pre-post clinical trial. RESULTS: There is a limited evidence concerning clinical efficacy of topical corticosteroids. Clobetasol, dexamethasone, and budesonide were the topical corticosteroid of choice. The highest level of evidence score was given to clobetasol followed by budesonide with a lower evidence level. CONCLUSION: All three topical corticosteroid preparations are effective for management of oral chronic GVHD with minimal easily avoided side effects.
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spelling pubmed-55116362017-07-27 Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease Elsaadany, Basma Abdelaleem Ahmed, Eman Magdy Aghbary, Sana Maher Hasan Int J Dent Review Article BACKGROUND: Oral chronic graft versus host disease (cGVHD) is a major complication in transplantation community, a problem that can be addressed with topical intervention. Topical corticosteroids are the first line of treatment although the choice remains challenging as none of the available treatments is supported by strong clinical evidence. OBJECTIVE: This systematic review aims to determine the clinical efficacy and safety of topical corticosteroids for the management of the mucosal alterations of oral cGVHD. DATA SOURCES: Electronic search of different databases was conducted: PubMed, Cochrane library, Grey literature, WHO, and clinical trials.gov for clinical trial registration as well as hand search in the references of relevant articles up to November 2016. DATA EXTRACTION: Extracted pieces of information were intervention, population, sample sizes, and outcomes. DATA SYNTHESIS: Six studies were included: 2 randomized clinical trials (RCTs), 3 cohort studies, and 1 pre-post clinical trial. RESULTS: There is a limited evidence concerning clinical efficacy of topical corticosteroids. Clobetasol, dexamethasone, and budesonide were the topical corticosteroid of choice. The highest level of evidence score was given to clobetasol followed by budesonide with a lower evidence level. CONCLUSION: All three topical corticosteroid preparations are effective for management of oral chronic GVHD with minimal easily avoided side effects. Hindawi 2017 2017-07-02 /pmc/articles/PMC5511636/ /pubmed/28751912 http://dx.doi.org/10.1155/2017/1908768 Text en Copyright © 2017 Basma Abdelaleem Elsaadany et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Elsaadany, Basma Abdelaleem
Ahmed, Eman Magdy
Aghbary, Sana Maher Hasan
Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease
title Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease
title_full Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease
title_fullStr Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease
title_full_unstemmed Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease
title_short Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease
title_sort efficacy and safety of topical corticosteroids for management of oral chronic graft versus host disease
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5511636/
https://www.ncbi.nlm.nih.gov/pubmed/28751912
http://dx.doi.org/10.1155/2017/1908768
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