Management of oral Graft versus Host Disease with topical agents: A systematic review
Med. oral patol. oral cir. bucal (Internet)
; 21(1): e72-e81, ene. 2016. graf, tab
Artigo
em Inglês
| IBECS
| ID: ibc-149428
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
BACKGROUND:
Oral Graft-versus-Host Disease (oGvHD) is a common complication of haematopoietic stem cell transplantation. Choosing the right topical application to be used intra orally can be a challenge. Consequently, the aim of this work is to review the effectiveness and safety of topical agents currently used in the management of the inflammatory mucosal lesions encountered in oGVHD. MATERIAL ANDMETHODS:
We carried out electronic searches of publications up to May 2015 of the databases Pubmed, National Library of Medicine's Medline, Embase and the Cochrane Central Register of Controlled Clinical trials to identify potentially relevant studies (keywords "oral", "graft", "versus", "host", "disease" and "treatment"). The main inclusion criterion was the reported use of a topical agent which was not intentionally swallowed when used for the treatment of oGVHD. A 3-point grading system, described by the Swedish Council on Technology Assessment in Health Care and the Centre for Reviews and Dissemination, University of York, was used to rate the methodological quality of the papers.RESULTS:
From the 902 entries identified in the search, 7 studies qualifying for inclusion were analysed. Overall, there is limited evidence with regards to the effectiveness of topical steroids for oGVHD. However, the studies showed some effect of Budesonide alone and when combined with dexamethasone. Topical tacrolimus also appears to have some effect and clobetasol propionate mouthwash had a significantly better clinical response than dexamethasone mouthwash in treating oGVHD.CONCLUSIONS:
As the number of clinical trials conducted is limited, there is little evidence to support the use of topical therapies to treat the inflammatory mucosal lesions found in oGVHD. High quality randomised control trials are needed in order to measure the effectiveness of any topical application for the treatment of the inflammatory mucosal lesions found in oGVHD
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Base de dados:
IBECS
Assunto principal:
Estomatite
/
Transplante de Células-Tronco Hematopoéticas
/
Doença Enxerto-Hospedeiro
Tipo de estudo:
Ensaio clínico controlado
/
Avaliação de tecnologias de saúde
/
Estudo prognóstico
/
Revisão sistemática
Limite:
Humanos
Idioma:
Inglês
Revista:
Med. oral patol. oral cir. bucal (Internet)
Ano de publicação:
2016
Tipo de documento:
Artigo
Instituição/País de afiliação:
Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS)/Portugal
/
King's College London Dental Institute/United Kingdom
/
University of Barcelona/Spain
/
University of Birmingham/United Kingdom