[Effectiveness of pidotimod in combination with bacterial lysates in the treatment of the pfapa (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome].
OBJECTIVE
PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome is the most common autoinflammatory syndrome in pediatrics, accepted as an hyperimmune condition. Pidotimod is a molecule with immunomodulatory activity on both innate and adaptive immune responses; it also has the capacity to modulate the function of the respiratory epithelial cells through the activation of a NK-KB pathway which would involve the host-virus interaction. Moreover, the proven beneficial effect of Pidotimod in enhancing the immune response during vaccination, and its benefits in the prevention of respiratory tract infections, should be noted.


METHODS
A joint combination of Pidotimod and bacterial lysates was used to treat 37 children with a clinical diagnosis of PFAPA; within the end of the first year of therapy, the healing rate of PFAPA symptoms was 67.5% (25 children), with a 10.8% (4 cases) still in complete remission within the end of the second year of follow-up.


RESULTS
It is important to highlight that 29 children (78.3%) had benefitted from this therapy, in terms of healing, with a marked decrease in the incidence of fever from a total of 360 to 106 episodes, and episodes of periodic fever occurring almost 4 times less frequently. The use of Pidotimod determined a significant reduction of surgical tonsillectomy's treatment.


CONCLUSIONS
This approach had a strong impact on the children's quality of life; a significant decrement in the use of antipyretic drugs, as well as a lower rate of antibiotic prescription, were also noted. It also had a dramatic impact on families' lives, because the treatment lowers the number of absences of family members from work or school/kindergarten.
Dipartimento di Otorinolaringologia, Università di Firenze, Firenze, Italia - n.pierossi@gmail.com.
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Buongiorno
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Pierossi
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D002457:Cell Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000276:immunology; D005500:Follow-Up Studies; D006801:Humans; D008199:Lymphadenitis / Q000188:drug therapy / Q000276:immunology; D008297:Male; D010612:Pharyngitis / Q000188:drug therapy / Q000276:immunology; D011761:Pyrrolidonecarboxylic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011788:Quality of Life; D013281:Stomatitis, Aphthous / Q000188:drug therapy / Q000276:immunology; D013577:Syndrome; D053778:Thiazolidines / Q000008:administration & dosage / Q000627:therapeutic use*; D000095983:Bacterial Lysates
D000276:Adjuvants, Immunologic; D002457:Cell Extracts; D011761:Pyrrolidonecarboxylic Acid; D053778:Thiazolidines; C030259:Broncho-Vaxom; D000095983:Bacterial Lysates; C064893:pidotimod