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[beta]-blockers effectively clear aphthous ulcers. (May Ease Effects of Stress).

PARIS -- The [beta]-blocker propranolol appears to be fairly effective at clearing recurrent aphthous ulcers, Dr. Mehdi Moezzi reported at the 20th World Congress of Dermatology.

Dr. Moezzi, of the department of dermatology at the University of Pecs (Hungary), observed that patients with recurrent aphthous ulcers often had complete clearances or reduced frequency of recurrence when they began [beta]-blocker therapy for the management of their cardiovascular disease.

To test the potential efficacy of a [beta]-blocker in normotensive individuals with aphthous ulcers, 179 patients, aged 20-39 years, with 3-4 years of recurrent bouts of aphthous ulcers were randomized either to treatment with low-dose propranolol or placebo.

Patients had between two and seven ulcers at baseline, and had recurrences every 6-8 weeks. All of them had blood pressures within the normal range and had no abnormalities on ECG.

Patients in the study had idiopathic aphthous ulcers. Individuals with active herpes simplex virus infections, Behcet's disease, or other conditions that might cause similar oral lesions were excluded from the trial.

The propranolol was dosed according to the following regimen: for the first 7 days, patients were instructed to take 10 mg, thrice daily for a total of 30 mg per day; for the following 7 days, the dose was cut down to twice daily for a total of 20 mg; and for the following 65 days, they took one daily 10-mg dose.

Dr. Moezzi stressed that from the cardiologic point of view, this dosing regimen is subtherapeutic. Blood pressure and hemodynamic measurements at the end of week 1, week 2, and at the midpoint of the 65-day maintenance period showed no changes in blood pressure, EGG tracings, or serum ion levels. In the active treatment group, 72 of 95 patients (68%) had complete clearances of their aphthous ulcers. The remaining 23 patients had partial improvements with fewer, smaller, and less painful lesions. Dr. Moezzi noted that "some patients have been disease free for 3 years now" There were no observed adverse effects in the patients treated with the [beta]-blocker.

In contrast, 6 of 84 patients on placebo had partial improvements, and none had complete resolution of their lesions.
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Author:Goldman, Erik L.
Publication:Internal Medicine News
Geographic Code:4EXHU
Date:Oct 15, 2002
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