Pharmacokinetics study about topical clobetasol on oral mucosa

Varoni, Elena Maria; Molteni, Alessia; Sardella, Andrea; Carrassi, Antonio; Candia, Domenico Di; Gigli, F.; Lodi, F; Lodi, Giovanni

doi:10.1111/j.1600-0714.2011.01087.x

Cited by 29 publications

(21 citation statements)

References 26 publications

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“…Side-effects of TCSs are relatively uncommon, generally mild and most of the time local, although systemic absorption was recently demonstrated. 44 Because of different inclusion and exclusion criteria, results of this study are not comparable with the review by Chan et al, 13 in fact, although there has been an increase in the number of studies, some of the studies and one class of drugs (retinoids) previously included were not considered. However, after more than 10 years there is still a lack of strong evidence supporting the effectiveness of any specific palliative treatment for symptomatic OLP.…”

Section: Discussionmentioning

confidence: 74%

See 1 more Smart Citation

Interventions for treating oral lichen planus: a systematic review

Lodi

Carrozzo

Furness

et al. 2012

British Journal of Dermatology

126

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Oral lichen planus (OLP) is a common chronic inflammatory disease associated with cell-mediated immunological dysfunction. Symptomatic OLP is painful and complete healing is rare. The aim of this review was to assess the evidence for the efficacy and safety of treatments for symptomatic OLP. The Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched in January 2011 to identify all randomized controlled trials (RCTs) evaluating any intervention for the treatment of symptomatic OLP. A total of 28 trials were included in this Cochrane review. There was no evidence from three RCTs that topical pimecrolimus is better than placebo in reducing pain from OLP. There was weak evidence from two RCTs that topical aloe vera may be associated with a reduction in pain compared with placebo. There was weak and unreliable evidence from two small trials, at high risk of bias, that topical ciclosporin may reduce pain and clinical signs of OLP. There was no evidence (from five trials each evaluating a different steroid and/or calcineurin inhibitor) that there is a difference between treatment with topical corticosteroids (TCSs) compared with topical calcineurin inhibitors with regard to reducing pain associated with OLP or that any specific steroid therapy is more or less effective at reducing pain. Although TCSs are considered to be the first-line treatment, we did not identify any RCTs that compared TCSs with placebo in patients with symptomatic OLP. From the 28 trials included in this systematic review, the wide range of interventions compared means there is insufficient evidence to support the superior effectiveness of any specific treatment.

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Section: Discussionmentioning

confidence: 74%

“…Side‐effects of TCSs are relatively uncommon, generally mild and most of the time local, although systemic absorption was recently demonstrated 44 …”

Section: Discussionmentioning

confidence: 99%

Interventions for treating oral lichen planus: a systematic review

Lodi

Carrozzo

Furness

et al. 2012

British Journal of Dermatology

126

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“…An unexpected increase in the resting SFR in patients using topical clobetasol was observed in the present study. Clobetasol is known to penetrate the oral mucosa, especially in the presence of atrophic or ulcerated mucosal lesions [38]. The permeability of the oral mucosa is estimated to be 4 to 4000 times greater than that of the skin [39].…”

Section: Discussionmentioning

confidence: 99%

Randomized Double-Blind Clinical Trial Comparing Clobetasol and Dexamethasone for the Topical Treatment of Symptomatic Oral Chronic Graft-Versus-Host Disease

Noce

Gomes

Shcaira

et al. 2014

Biology of Blood and Marrow Transplantation

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Patients who undergo allogeneic stem cell transplantation frequently develop an immunologic disease caused by the reactivation of the graft to the host tissues. This disease is called graft-versus-host disease (GVHD) and it is usually a systemic disorder. In a large proportion of cases, oral disorders that are related to a chronic phase of GVHD (cGVHD) occur, and their treatment involves the use of topical immunosuppressive drugs. Several medications have been studied for this purpose, but only a small number of clinical trials have been published. The present study is a randomized, double-blind clinical trial that compares topical clobetasol and dexamethasone for the treatment of symptomatic oral cGVHD. Patients were randomly assigned to treatment with clobetasol propionate .05% or dexamethasone .1 mg/mL for 28 days. In both arms, nystatin 100,000 IU/mL was administered with the corticosteroid. Oral lesions were evaluated by the modified oral mucositis rating scale (mOMRS) and symptoms were registered using a visual analogue scale. Thirty-five patients were recruited, and 32 patients were randomized into the study groups: 18 patients (56.3%) to the dexamethasone group and 14 patients (43.8%) to the clobetasol group. The use of clobetasol resulted in a significant reduction in mOMRS total score (P = .04) and in the score for ulcers (P = .03). In both groups, there was significant symptomatic improvement but the response was significantly greater in the clobetasol group (P = .02). In conclusion, clobetasol was significantly more effective than dexamethasone for the amelioration of symptoms and clinical aspects of oral lesions in cGVHD.

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“…31 Bu çalışmalarda tavsiye edilen tedavi dozlarının miligram yerine literatürde "fingertip" olarak adlandırılan parmak ucu ünitesi şeklinde olduğu ve Candida enfeksiyonundan kaçınmak için genellikle %0,2 klorheksidin gargaranın da tedaviye eklenmesinin önerildiği görülmektedir. 9,28 Parmak ucu ünitesi kullanımı (yaklaşık 0,5 gram) işaret parmağının ucundan distal interfalangeal eklem hizasına kadar tüpün ucuyla sürülen miktarı ifade etse de, hem tedavi sonucunu değiştirecek, hem de tedavi sonrası görülebilecek potansiyel yan etkilere neden olabilecek, standart ve numerik olmayan bir tedavi dozunu ifade eder. 32…”

Section: (Resim 2)unclassified

“…1,3 TS'nin etkinlik gücü hem tedavi başarısını hem de oluşabilecek yan etkileri belirleyen başlıca faktörler arasındadır. [3][4][5][6][7][8][9] Literatürde TS'lerin etki gücüne göre sınıflandırıldığı ve özellikle Avrupa'da kabul gören başlıca üç sınıflama göze çarpmaktadır. Anatomik Terapötik Kimyasal (Anatomical Therapeutic Chemical-ATC)/Dünya Sağlık Örgütü (World Health Organization -WHO), İngiliz Ulusal Formüleri (British National Formulary) ve Niedner sınıflamalarında bu ilaçlar dört farklı alt gruba ayrılmış olup; Sınıf I hafif, Sınıf II orta, Sınıf III güçlü ve Sınıf IV en güçlü etkili kortikosteroidleri temsil etmektedir.…”

Section: Introductionunclassified

Topical steroids in dentistry: Adverse effects and proposal for application

Gürhan¹,

Güneri²

2019

Yeditepe J Dent

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Topikal, sistemik, inhalasyonel, rektal ve intraartiküler ajanlar olarak kullanılabilen glikokortikoidler genellikle enflamatuvar, alerjik, otoimmün ve neoplastik hastalıkların tedavisinde tercih edilirler. Özellikle bu ajanlardan topikal formda olanlar oral mukozal hastalıklarla ilişkili ağız lezyonlarının tedavisinde kullanılmaktadırlar. Bu nedenle oral mukozal hastalıklarda etkili bir tedavi sağlamak ve aynı zamanda hastaları potansiyel yan etkilerden korumak için diş hekimleri topikal steroidlerin (TS) endikasyonlarını, yan etkilerini ve klinik uygulama şekillerini bilmelidirler. Doğru şekilde kullanıldığında birçok oral mukozal hastalıkta tatmin edici klinik sonuçlar sağlayan TS'nin, hatalı uygulamalar sonucunda iyatrojenik Cushing sendromu, adrenal yetmezlik gibi ciddi komplikasyonlara neden olabileceğine dair birçok çalışma bulunmaktadır. Literatürde, TS'nin hangi dozdan ve uygulama sıklığından sonra sistemik kan dolaşımına katıldığına ilişkin bir görüş birliğine varılamamıştır. Sunulan bu derlemede, son yıllarda diş hekimleri tarafından sıklıkla reçete edilmeye başlayan TS'nin endikasyon ve kontrendikasyonları ile avantaj ve dezavantajlarının yanı sıra, güncel literatür bilgileri ışığında doğru kullanım önerilerinin paylaşılması amaçlanmıştır. Anahtar kelimeler: Diş hekimliği, topikal steroid, yan etki. SUMMARY Glucocorticoids, which are used as topical, systemic, inhalational, rectal and intraarticular agents, are often preferred for treatment of inflammatory, allergic, autoimmune and neoplastic diseases. Especially, topical forms of these agents are used to treat oral lesions associated with oral mucosal diseases. Therefore, dentists must know indications, side effects and application forms of topical steroids (TS) in order to treat oral mucosal diseases effectively, and to protect the patients from potential side effects. There are many studies, suggesting that when TS are used properly, they provide satisfactory clinical results in many oral mucosal diseases; whereas it may lead to serious complications, such as iatrogenic Cushing syndrome and adrenal insufficiency, as a result of inaccurate applications. In the literature, there is no consensus about the posology of TS, which results in the absorption of the TS into systemic circulation. The aims of this review are to offer indications, contraindications, advantages, and disadvantages of TS, which have been frequently prescribed by dentists in recent years, as well as to share suggestions for proper usage of these drugs in accordance with the current information in the literature.

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Pharmacokinetics study about topical clobetasol on oral mucosa

Abstract: Our study validates clobetasol systemic transmucosal absorption, also recommending a careful monitoring of patients in corticosteroid therapy to avoid local and systemic adverse effects.

Cited by 29 publications

References 26 publications

Interventions for treating oral lichen planus: a systematic review

Interventions for treating oral lichen planus: a systematic review

Randomized Double-Blind Clinical Trial Comparing Clobetasol and Dexamethasone for the Topical Treatment of Symptomatic Oral Chronic Graft-Versus-Host Disease

Topical steroids in dentistry: Adverse effects and proposal for application

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