Evaluation of Topical Rebamipide Versus Topical Betamethasone for Management of Oral Ulcers in Behcet's Disease
Study Details
Study Description
Brief Summary
The goal of this randomized clinical trial is to to compare the effect of topical rebamipide to topical betamethasone on oral ulcer severity in patients with Behcet's disease.. The main question it aims to answer is :
What is the effect of topical Rebamipide mouthwash compared to topical betamethasone mouthwash in management of oral ulcers in Behcet's disease?
Participants will will be divided randomly into the two groups and the following outcomes will be measured:
The oral ulcers severity Pain associated with oral ulcers Number of oral ulcers Healing time of oral ulcers
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1/Phase 2 |
Detailed Description
This is a Randomized clinical trial (RCT) parallel groups, two arm, equivalence framework with 1:1 allocation ratio which is based on the hypothesis that Topical rebamipide has comparable effect to topical betamethasone on oral ulcer severity in patients with Behcet's disease The participants in this study will be recruited from the Rheumtology Clinic, Kasr el ainy hospital by HL as well as Oral Medicine Clinic and the dental Diagnostic center, Faculty of Dentistry, by MB. The eligible participants will be enrolled in the study in a consecutive order till the sample size is achieved.
Simple randomization will be generated using computerized random number generator (random.org) with allocation ratio (1:1).
Allocation concealment will be done using sequentially numbered opaque sealed opaque containers of the same shape, size and colour until interventions are assigned.
The entire procedure will be explained to the patients and a written consent will be obtained by the operator.
Participants and care givers will be blinded as both topical rebamipide and topical betamethasone mouthwashes will be of same consistency and will be provided in sealed opaque containers of the same shape, size and colour.
The enrolled patients will be divided randomly into two groups. One group will receive topical rebamipide mouthwash four times daily for one week or till healing and the other group will receive topical Corticosteroid (topical betamethasone) four times daily for one week or till healing. The patients will be recalled during the first week (days 1, 3, and 7), then every week for 3 weeks, afterward every month for 2 months. The patients will be asked to prohibit use of any topical medication during the trial. Outcome measures will be recorded in each visit.
Data will be analyzed using IBM SPSS advanced statistics (Statistical Package for Social Sciences), version 24 (SPSS Inc., Chicago, IL)
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Rebamipide mouthwash Rebamipide mouthwash will be administered four times daily for one week or till healing |
Drug: Rebamipide mouthwash
Rebamipide (REB), 2-(4-chlorobenzoylamino)-3-[2(1H)-quinolinone-4-yl]-propionic acid, is commonly used in cases of gastric ulcers, gastritis, and dry eye syndrome
Other Names:
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Active Comparator: Betamethasone mouthwash Betamethasone mouthwash of will be administered four times daily for one week or till healing |
Drug: Betamethasone mouthwash
Betamethasone is a potent glucocorticoid steroid. It is very soluble in water, and therefore it can be used as a mouthwash and has been used for symptomatic relief and treatment of recurrent aphthous ulcers
Other Names:
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Outcome Measures
Primary Outcome Measures
- oral ulcer severity [During the first week (days 1, 3, and 7), then every week for 3 weeks, afterward every month for 2 months.]
oral ulcer severity score (OUSS). OUSS indicates the disease activity in recurrent oral ulcers., as the change in the numerical score reflects the change in ulcer severity in response to treatment
Secondary Outcome Measures
- Pain associated with oral ulcers [During the first week (days 1, 3, and 7), then every week for 3 weeks, afterward every month for 2 months.]
pain from oral ulcers will be assessed through visual analogue scale
- Number of oral ulcers [During the first week (days 1, 3, and 7), then every week for 3 weeks, afterward every month for 2 months.]
Number of oral ulcers will be determined through clinical examination
- healing time of oral ulcers [During the first week (days 1, 3, and 7), then every week for 3 weeks, afterward every month for 2 months.]
healing time of oral ulcers will be determined through clinical examination
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients diagnosed with Behcet's disease as defined by the revised International Criteria for Behcet's Disease (ICBD2014).
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Patients with active oral ulcers.
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Patients free from any visible oral lesions other than the oral ulcers of BD.
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Patient who will agree to participate in the study and take the supplied interventions.
Exclusion Criteria:
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Patients with history of a severe or chronic medical condition including congestive heart failure, malignancy and active infection including tuberculosis, hepatitis and human immunodeficiency virus.
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Patients who refuse to sign the informed consent.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Cairo University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
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- Alibaz-Oner F, Direskeneli H. Advances in the Treatment of Behcet's Disease. Curr Rheumatol Rep. 2021 May 20;23(6):47. doi: 10.1007/s11926-021-01011-z.
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- International Team for the Revision of the International Criteria for Behcet's Disease (ITR-ICBD). The International Criteria for Behcet's Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol. 2014 Mar;28(3):338-47. doi: 10.1111/jdv.12107. Epub 2013 Feb 26.
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- Nagai N, Seiriki R, Deguchi S, Otake H, Hiramatsu N, Sasaki H, Yamamoto N. Hydrogel Formulations Incorporating Drug Nanocrystals Enhance the Therapeutic Effect of Rebamipide in a Hamster Model for Oral Mucositis. Pharmaceutics. 2020 Jun 9;12(6):532. doi: 10.3390/pharmaceutics12060532.
- Novak T, Hamedi M, Bergmeier LA, Fortune F, Hagi-Pavli E. Saliva and Serum Cytokine Profiles During Oral Ulceration in Behcet's Disease. Front Immunol. 2021 Dec 22;12:724900. doi: 10.3389/fimmu.2021.724900. eCollection 2021.
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- Senusi A, Kang A, Buchanan JAG, Adesanya A, Aloraini G, Stanford M, Fortune F. New mouthwash: an efficacious intervention for oral ulceration associated with Behcet's disease. Br J Oral Maxillofac Surg. 2020 Oct;58(8):1034-1039. doi: 10.1016/j.bjoms.2020.07.027. Epub 2020 Jul 25.
- Tappuni AR, Kovacevic T, Shirlaw PJ, Challacombe SJ. Clinical assessment of disease severity in recurrent aphthous stomatitis. J Oral Pathol Med. 2013 Sep;42(8):635-41. doi: 10.1111/jop.12059. Epub 2013 Mar 19.
- Taylor J, Glenny AM, Walsh T, Brocklehurst P, Riley P, Gorodkin R, Pemberton MN. Interventions for the management of oral ulcers in Behcet's disease. Cochrane Database Syst Rev. 2014 Sep 25;2014(9):CD011018. doi: 10.1002/14651858.CD011018.pub2.
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