title: Comparison of budesonide and dexamethasone for local treatment of oral chronic graft-versus-host disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cancer Center Unit, Department of Pharmacy, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea.
authors.forename: Ae Ryoung
authors.initials: AR
authors.lastname: Park
authors.forename: Hyen Oh
authors.initials: HO
authors.lastname: La
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Cho
authors.forename: Soon Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Byung Koo
authors.initials: BK
authors.lastname: Lee
authors.forename: Jeong Yeon
authors.initials: JY
authors.lastname: Rhie
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Gwak
mesh_terms: D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications / Q000188:drug therapy*; D009067:Mouthwashes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D009067:Mouthwashes; D019819:Budesonide; D003907:Dexamethasone