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Rebamipide (Regular & Nanoparticulated) vs. Clobetasol in Management of Methotrexate-Induced Oral Ulceration in Rheumatoid Arthritis Patients

Phase 3
Recruiting
Conditions
Rheumatoid Arthritis
Interventions
Registration Number
NCT04649697
Lead Sponsor
Cairo University
Brief Summary

The aim of this intervention study is to compare the effect of topical Rebamipide (regular and nanoparticulated) to topical Clobetasol propionate in management of Methotrexate induced oral mucositis in patients with rheumatoid arthritis.

Detailed Description

A random sample of patients diagnosed with rheumatoid arthritis attending at the Rheumatology clinic in faculty of Medicine, Cairo University Hospital, will be enrolled by the investigator in the study in a consecutive order after being examined for methotrexate induced oral ulceration by means of history and clinical examination.

Since oral mucositis associated with Methotrexate include production of free radicals, increase of inflammatory cytokines, and alteration of intracellular signal transduction, this suggests that Rebamipide should be useful for its treatment and prevention. Thus, this RCT will be the first to evaluate the treatment of Methotrexate-induced oral mucositis using Rebamipide and Rebamipide nanoparticles in patients with rheumatoid arthritis.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
39
Inclusion Criteria
  • Patient who agreed to sign the informed consent.
  • Age: 20-70 years old.
  • Gender: males and females
  • RA patients treated with MTX and suffering from MTX-induced oral ulceration.
Exclusion Criteria
  • Patients refused to sign the informed consent.
  • Pregnant or lactating females in their child bearing age group.
  • patients with known or suspected history of hypersensitivity to any of the ingredients of the preparation of the drugs used.
  • Systemic disease: such as uncontrolled diabetes mellitus, auto-immune diseases known to cause oral ulceration, renal or liver dysfunction or any other condition considered risky by the clinician.
  • Patients treated with any medication for the condition at the time of setting.
  • Salivary gland diseases.
  • Malignancy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Nanoparticulated RebamipideNanoparticulated RebamipideThe enrolled subjects will be treated with nanoparticulated Rebamipide in mucoadhesive gel for 2 weeks or until complete healing.
RebamipideRebamipideThe enrolled subjects will be treated with Rebamipide in mucoadhesive gel for 2 weeks or until complete healing.
ClobetasolClobetasol PropionateThe enrolled subjects will be treated with Clobetasol in mucoadhesive gel for 2 weeks or until complete healing.
Primary Outcome Measures
NameTimeMethod
change in the Clinical improvement of oral ulcersassessment will be at baseline, 2 weeks and 4 weeks

Will be assessed using World Health Organization (WHO) grading of mucositis

Secondary Outcome Measures
NameTimeMethod
healing time of the ulcerassessment at 0, 2 weeks and 4 weeks

The total healing time of oral ulcers Will be recorded in days for all the patients.

Subjective degree of painPain assessment will be daily for the first week then at 2 weeks and 4 weeks.

All patients were introduced to the Numerical Rating Scale (NRS) and learnt how to express their pain through it, patients were instructed to fill the scale paper at the first visit \[baseline\], this procedure was repeated for each follow-up visit.

size of oral ulcerassessment at 0, 2 weeks and 4 weeks

The ulcer size was determined by measuring the distance between two opposite edges of the ulcer border, using a periodontal probe in millimeters.

Trial Locations

Locations (1)

Cairo University

🇪🇬

Cairo, Egypt

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