Prepubertal-Onset Vulvar Lichen Sclerosus: The Importance of Maintenance Therapy in Long-Term Outcomes

2015 ◽  
Vol 32 (4) ◽  
pp. 461-467 ◽  
Author(s):  
Elizabeth Ellis ◽  
Gayle Fischer
Keyword(s):  
Maintenance Therapy ◽  
Lichen Sclerosus ◽  
Long Term Outcomes ◽  
Vulvar Lichen Sclerosus

scholarly journals Long-term outcomes of office-based buprenorphine/naloxone maintenance therapy

2010 ◽  
Vol 106 (1) ◽  
pp. 56-60 ◽  
Author(s):  
T.V. Parran ◽  
C.A. Adelman ◽  
B. Merkin ◽  
M.E. Pagano ◽  
R. Defranco ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Long Term Outcomes

Novel Therapeutic Approaches and Targets for Treatment of Vulvar Lichen Sclerosus

2020 ◽  
Vol 22 (1) ◽  
pp. 99-114
Author(s):  
Alessandro Borghi ◽  
Monica Corazza
Keyword(s):  
Maintenance Treatment ◽  
English Literature ◽  
Lichen Sclerosus ◽  
Treatment Phase ◽  
Current Evidence ◽  
Systemic Treatments ◽  
Pubmed Database ◽  
Term Maintenance ◽  
Vulvar Lichen Sclerosus

Background: Vulvar Lichen Sclerosus (VLS) is a chronic inflammatory disease with a huge impact on a person’s quality of life. A correct therapy is required for relieving symptoms, reversing signs and preventing further anatomical changes. Objective: The main objective of the present paper is to provide suggestions for the best treatment approach, based on the available evidence. Treatment strategies are divided on the basis of the treatment phase, distinguishing options for initial, acute or attack treatment and those for long-term, maintenance treatment. Methods: An electronic search was performed using the National Library of Medicine PubMed database. All the studies evaluating treatment of vulvar lichen sclerosus published in the English literature were analyzed, including controlled studies, case series, guidelines and reviews. Results: Current evidence identifies ultra-potent and potent corticosteroids, administered for 12 weeks, as the first-line recommended treatment for active VLS. Topical calcineurin inhibitors, tacrolimus and pimecrolimus, are effective and safe alternatives. Long-term maintenance strategies aimed at preventing recurrences are required, after the initial treatment phase. Maintenance treatment mostly consists in topical corticosteroids, administered i) on an “as needed” basis (“reactive” scheme), ii) on a continuative regimen, iii) on a low-dose, intermittent regimen (“proactive” scheme). Further investigations are needed for better defining the placement of other options within the VLS therapeutic algorithm, including retinoids, physical and systemic treatments. Conclusion: The available evidence provides useful indications for the management of VLS. Both the identification of new therapeutic targets and the optimization of the available options represent the main objectives of future research.

scholarly journals Maintenance therapy is associated with better long-term outcomes in adult patients with primary angiitis of the central nervous system

Rheumatology ◽  
2017 ◽  
Vol 56 (10) ◽  
pp. 1684-1693 ◽  
Author(s):  
Hubert de Boysson ◽  
Jean-Jacques Parienti ◽  
Caroline Arquizan ◽  
Grégoire Boulouis ◽  
Nicolas Gaillard ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Maintenance Therapy ◽  
Adult Patients ◽  
Long Term Outcomes ◽  
Primary Angiitis ◽  
The Central Nervous System

scholarly journals Long-Term Outcomes and Predictive Factors of Hospitalized Patients with Severe Ulcerative Colitis Treated with Intravenous Corticosteroids

2021 ◽  
Vol 10 (22) ◽  
pp. 5413
Author(s):  
Elena De Cristofaro ◽  
Silvia Salvatori ◽  
Irene Marafini ◽  
Francesca Zorzi ◽  
Norma Alfieri ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Maintenance Therapy ◽  
Real Life ◽  
University Hospital ◽  
Clinical Relapse ◽  
Long Term Outcomes ◽  
Severe Ulcerative Colitis ◽  
Mayo Score

Background and Aims: Treatment with intravenous corticosteroids (IVCS) is a mainstay in the management of acute severe ulcerative colitis (UC). Although most patients respond to IVCS, little is known about the long-term outcomes. In this study, we assessed the long-term outcomes of IVCS in a real-life cohort. Methods: Disease activity, clinical relapse (partial Mayo score >4), the need for steroids or other maintenance therapies and the rates of colectomy and re-hospitalization were evaluated in consecutive patients admitted to the Tor Vergata University hospital between 2010 and 2020 for acute severe UC who responded to IVCS. Results: Eighty-eight patients were followed up with for a median period of 46 (range 6–133) months. Of these, 56 (64%) patients were treated with 5-aminosalycilic acid and 32 (36%) with immunomodulators or biologics after discharge. A total of 60 out of 88 patients (68%) relapsed, 28 (32%) were re-hospitalized, and 15 (17%) underwent a colectomy with no difference between the two maintenance therapy groups. The multivariate analysis showed that patients in clinical remission 6 months after discharge had a lower risk of relapse during the follow-up. Conclusions: Nearly two-thirds of patients with acute UC responding to IVCS experienced relapse after a median follow-up of 4 years, and this was not influenced by the maintenance therapy.

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