pulmicort and Mouth-Diseases

The results of a prospective study of topical budesonide versus topical dexamethasone therapy for oral manifestations of chronic graft-versus-host disease (cGVHD) are presented.. In a prospective single-center investigation, a cohort of patients who developed oral symptoms of cGVHD after allogeneic stem cell transplantation were assigned to topical treatment with 0.03% budesonide rinse (group A, n = 26) or 0.01% dexamethasone rinse (group B, n = 24). Diagnosis of oral cGVHD symptoms, clinical staging, and treatment response scoring were performed at baseline and one month later according to current National Institutes of Health consensus criteria.. At one-month follow-up, there was a significant decrease in the median oral cGVHD examination score in both groups (p < 0.001); the decrease in the median examination score was greater with budesonide versus dexamethasone therapy (2.5 points versus 1.0 point, p = 0.045). The rates of overall treatment response, including complete and partial responses, were 53.8% and 29.2% in groups A and B, respectively (p = 0.093). In addition, there was a significant decrease from baseline in the median self-rated oral pain severity score in group A (p < 0.001).. Patients who received topical budesonide or dexamethasone rinse to treat oral manifestations of cGVHD had decreased cGVHD severity and pain scores after 30 days compared with baseline scores, though no statistical differences were seen between groups.

Topics: Budesonide; Chronic Disease; Dexamethasone; Female; Graft vs Host Disease; Humans; Immunosuppressive Agents; Male; Medication Adherence; Middle Aged; Mouth Diseases; Mouthwashes

This clinical trial aims to evaluate the efficacy of budesonide, a newly registered steroid with high potency and low bioavailability, for the treatment of chronic oral graft versus host disease (GVHD).. Twelve patients with chronic resistant oral GVHD were treated with 3 mg budesonide/5 ml saline 2 to 3 times a day for up to 3 months. Oral manifestations were monitored, and mucosal response scored.. All patients responded positively to the mouthwash, and 7 of the 12 patients were scored as having "good" or "complete" recovery by both examiner and subject. An early response noted within the first 2 to 3 weeks of treatment was complemented by a probable cumulative effect seen during the first months of treatment.. Budesonide is suggested as an alternative treatment for chronic oral GVHD.

Topics: Adult; Anti-Inflammatory Agents; Budesonide; Chronic Disease; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Middle Aged; Mouth Diseases; Mouth Mucosa; Mouthwashes

Oral chronic graft versus host disease (cGVHD) is often refractory to systemic therapies. Additional topical treatment is commonly required. The potency of the agent, the vehicle and formulation in which it is delivered are all critical factors in determining the effectiveness of topical therapies. High potency of budesonide, combined with its very low bioavailability when absorbed through mucosal surfaces, increased the potential role in topical application for oral cGVHD. Viscous formulation increases mucosal contact time resulting in a greater decrease in mucosal inflammation. This short communication suggests that oral viscous budesonide should be considered as a potential new therapy in the management of oral cGVHD.

Topics: Administration, Topical; Budesonide; Child; Chronic Disease; Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Mouth Diseases; Mouth Mucosa; Oral Ulcer

Topics: Budesonide; Dexamethasone; Female; Graft vs Host Disease; Humans; Male; Mouth Diseases

Local immunosuppressive therapies without systemic effects represent a therapeutic advantage in management of immune/inflammatory oral mucosal conditions. Topical budesonide rinses were prescribed to patients with mucosal disease that was resistant to other intervention without side effects. A case of paraneoplastic pemphigus and a patient with oral graft-versus-host disease that had not responded to standard approaches to management were successfully managed with budesonide rinse application. The cases presented represent mucosal conditions that were successfully managed with topical application of budesonide with reduced risk of systemic effects.

Topics: Anti-Inflammatory Agents; Budesonide; Graft vs Host Disease; Humans; Immunosuppressive Agents; Leukemia, Lymphoid; Lymphoma, Follicular; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Mouthwashes; Mucocele; Neutrophil Infiltration; Paraneoplastic Syndromes; Pemphigus

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Female; Glucocorticoids; Humans; Mouth Diseases; Pemphigoid, Benign Mucous Membrane; Pregnenediones; Stomatitis, Aphthous; Ulcer