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Management of oral Graft versus Host Disease with topical agents: A systematic review
Albuquerque, Rui; Khan, Zahid; Poveda, Ana; Higham, Jonathan; Richards, Andrea; Monteiro, Luis; Jané-Salas, Enric; Lopez-Lopez, José; Warnakulasuriya, Saman.
Afiliação
  • Albuquerque, Rui; University of Birmingham. Oral Medicine Department School of Dentistry. Birmingham. United Kingdom
  • Khan, Zahid; University of Birmingham. Oral Medicine Department School of Dentistry. Birmingham. United Kingdom
  • Poveda, Ana; University of Birmingham. Oral Medicine Department School of Dentistry. Birmingham. United Kingdom
  • Higham, Jonathan; University of Birmingham. Oral Medicine Department School of Dentistry. Birmingham. United Kingdom
  • Richards, Andrea; University of Birmingham. Oral Medicine Department School of Dentistry. Birmingham. United Kingdom
  • Monteiro, Luis; Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS). Medicine and Oral Surgery Department. Paredes. Portugal
  • Jané-Salas, Enric; University of Barcelona. Dental School. Oral Medicine Department. Barcelona. Spain
  • Lopez-Lopez, José; University of Barcelona. Dental School. Oral Medicine Department. Barcelona. Spain
  • Warnakulasuriya, Saman; King's College London Dental Institute. Department of Oral Medicine. London. United Kingdom
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 AND

METHODS:

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
Assuntos

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

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
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