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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Main Authors: Basma Abdelaleem Elsaadany, Eman Magdy Ahmed, Sana Maher Hasan Aghbary
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:International Journal of Dentistry
Online Access:http://dx.doi.org/10.1155/2017/1908768
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author Basma Abdelaleem Elsaadany
Eman Magdy Ahmed
Sana Maher Hasan Aghbary
author_facet Basma Abdelaleem Elsaadany
Eman Magdy Ahmed
Sana Maher Hasan Aghbary
author_sort Basma Abdelaleem Elsaadany
collection DOAJ
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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institution Kabale University
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spelling doaj-art-c05185ccd04442378d5b6b45bf62efba2025-02-03T06:11:02ZengWileyInternational Journal of Dentistry1687-87281687-87362017-01-01201710.1155/2017/19087681908768Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host DiseaseBasma Abdelaleem Elsaadany0Eman Magdy Ahmed1Sana Maher Hasan Aghbary2Faculty of Dentistry, Cairo University, Giza, EgyptFaculty of Oral and Dental Medicine, Beni Suef University, Beni Suef, EgyptFaculty of Dentistry, Aden University, Aden, YemenBackground. 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.http://dx.doi.org/10.1155/2017/1908768
spellingShingle Basma Abdelaleem Elsaadany
Eman Magdy Ahmed
Sana Maher Hasan Aghbary
Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease
International Journal of Dentistry
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
url http://dx.doi.org/10.1155/2017/1908768
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AT emanmagdyahmed efficacyandsafetyoftopicalcorticosteroidsformanagementoforalchronicgraftversushostdisease
AT sanamaherhasanaghbary efficacyandsafetyoftopicalcorticosteroidsformanagementoforalchronicgraftversushostdisease