Oh Jongwook, Lee Jae-Won, Chung Kyung Bae, Bang Dongsik, Kim Do-Young
Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Dermatology, Catholic Kwandong University International St. Mary's Hospital, Incheon, Korea.
Ann Dermatol. 2022 Feb;34(1):22-27. doi: 10.5021/ad.2022.34.1.22. Epub 2022 Jan 27.
Recurrent aphthous stomatitis (RAS) is a common disorder characterized by episodic ulcerations in the oral mucosa. Although colchicine has been a common systemic treatment for RAS, there is still considerable uncertainty regarding its efficacy and drug survival in this setting.
We aimed to study drug survival, efficacy, and safety of colchicine for the treatment of RAS, especially in the real clinical setting.
Between 2012 and 2016, 150 patients given colchicine for RAS were selected for a single-centre retrospective study of real-world efficacy and drug survival.
Among the 114 patients who qualified, 81.6% showed moderate or substantial responses (>25% improvement). Gastrointestinal complications (16.7%), neutropenia (3.5%), and liver enzyme elevation (4.4%) were reported within 2 weeks after initiating treatment. Delayed adverse manifestations were rare. One year after onset, colchicine use was sustained in roughly one-half (49.5%) of patients, whereas many (30.3%) had discontinued the drug, primarily due to lack of efficacy or adverse events. In Cox proportional hazard analysis, minor ulcers were identified as potential determinants of longer drug survival owing to less probability of non-efficacy. However, major ulcers had emerged as predictors of early discontinuation due to lack of efficacy.
In patients with RAS, colchicine may be an effective and safe treatment amenable to long-term maintenance. Monitoring of adverse events within 2 weeks after initiating treatment is advisable to ensure safe administration.
复发性阿弗他口炎（RAS）是一种常见疾病，其特征为口腔黏膜反复发作溃疡。尽管秋水仙碱一直是RAS常用的全身治疗药物，但在这种情况下其疗效和药物留存率仍存在相当大的不确定性。
我们旨在研究秋水仙碱治疗RAS的药物留存率、疗效和安全性，尤其是在实际临床环境中。
在2012年至2016年期间，选择150例接受秋水仙碱治疗RAS的患者进行单中心回顾性研究，以评估其实际疗效和药物留存率。
在符合条件的114例患者中，81.6%表现出中度或显著反应（改善>25%）。在开始治疗后2周内报告了胃肠道并发症（16.7%）、中性粒细胞减少（3.5%）和肝酶升高（4.4%）。延迟出现的不良反应很少见。发病一年后，约一半（49.5%）的患者持续使用秋水仙碱，而许多患者（30.3%）已停药，主要是由于缺乏疗效或出现不良事件。在Cox比例风险分析中，轻微溃疡被确定为药物留存时间较长的潜在决定因素，因为无效的可能性较小。然而，严重溃疡已成为因缺乏疗效而早期停药的预测因素。
对于RAS患者，秋水仙碱可能是一种有效且安全的可长期维持的治疗方法。建议在开始治疗后2周内监测不良事件，以确保安全用药。
