Colchicine efficacy on oral ulcers caused by Behcet's spectrum disorders including idiopathic recurrent aphthous stomatitis, PFAPA, and Behcet's Disease

Abstract

Recurrent aphthous stomatitis (RAS) is a common condition in pediatric age. Since there are significant genetic commonalities among idiopathic cases, periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA), and Beh & ccedil;et's disease (BD), they were proposed to be considered in one clinical spectrum termed Beh & ccedil;et's Spectrum Disorders (BSDs). This retrospective study aimed to evaluate the efficacy of colchicine on oral ulcers in children with BSD related RAS (BSD-RAS). Secondary aim was to compare the disease groups in terms of clinical and laboratory benefits. Data at admission and one year-after the treatment initiation were compared. A total of 317 patients with RAS were evaluated, and 186 patients classified as BSD-RAS (Female: n = 105, 56%). The median age at symptom onset was 5 (0.5-16.5) years. Colchicine was started to 142 (76%) patients. We observed a significant reduction in the frequency and duration of oral ulcers, as well as in the visual analogue scale (VAS) scores reported by patients/families and physicians, and the erythrocyte sedimentation rate during symptom-free periods across all three groups. In patients with PFAPA, both difference between initial and final recorded values (Delta) patient/families and Delta physician VAS scores were significantly higher than in other groups (p < 0.001). Furthermore, both Delta duration (p = 0.005) and Delta frequency of oral aphthae (p = 0.012) were significantly higher in idiopathic cases than those with PFAPA. Conclusion: These findings demonstrate a substantial reduction in both clinical symptoms and laboratory markers following colchicine treatment, supporting its effectiveness as a therapeutic option for BSD-RAS.