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Clobetasol for Oral Graft-Versus-Host Disease

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Cancer Institute (NCI) ) Identifier:
First received: March 16, 2012
Last updated: April 20, 2017
Last verified: February 28, 2017


- Oral graft-versus-host disease (GVHD) is a possible complication of bone marrow transplants. It is the result of the donor cells trying to attack the recipient s body. Symptoms include dry mouth, sensitivity and pain when tasting certain spices and flavors, and painful swallowing. Steroids are a possible effective treatment for GHVD, but they can cause side effects when given as pills or injections. Steroids given in a cream or rinse form, applied directly to the site of the symptoms, can have fewer side effects. However, their effectiveness as a rinse has not been tested in the mouth. Researchers want to see if a steroid called clobetasol can be used as a mouth rinse to treat oral GHVD.


- To see if a clobetasol rinse is a safe and effective treatment for oral graft-versus-host disease.


- Individuals at least 12 years of age who have oral GHVD and are not allergic to clobetasol.


  • Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected. They will also have an oral exam, a mouth tissue biopsy, and other tests before starting the study drug.
  • Participants will be separated into two groups. One group will receive clobetasol; the other will have a placebo liquid.
  • Participants will rinse their mouths with the study liquid three times a day after meals for 2 weeks.
  • After 2 weeks, participants will have another study visit with blood tests and other exams.
  • After the study visit, all participants will start to use the clobetasol rinse. Those who originally had clobetasol will use the rinse for another 2 weeks. Those who originally had a placebo will use the rinse for 4 weeks.
  • Participants will have a follow-up exam after the end of treatment....

Condition Intervention Phase
Oral Chronic Graft vs Host Disease
Drug: Clobetasol Oral Rinse
Drug: Placebo oral rinse
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Participant, Outcomes Assessor
Primary Purpose: Treatment
Official Title: A Randomized Double-Blind Pilot Study of Topical Clobetasol 0.05% Oral Rinse for Oral Chronic Graft-Versus-Host-Disease

Resource links provided by NLM:

Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • To investigate efficacy of topical clobetasol 0.05% oral rinse for oral chronic graft-versus-host-disease (cGVHD) during a four-week treatment period as assessed by Oral Mucositis Rating Scale (OMRS). [ Time Frame: 1 month ]

Secondary Outcome Measures:
  • To assess the effect of topical clobetasol on oral cGVHD related pain, sensitivity, and dryness. [ Time Frame: 1 month ]
  • To evaluate the basic pharmacodynamics and pharmacokinetics of clobetasol mouth rinse in cGVHD patients. [ Time Frame: 1 month ]

Enrollment: 37
Study Start Date: January 25, 2012
Estimated Study Completion Date: January 1, 2018
Estimated Primary Completion Date: January 1, 2018 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Group 1
Patients will rinse oral cavity with 10cc of clobetasol 0.05% for 2 minutes 3 times a day.
Drug: Clobetasol Oral Rinse
Cycle= up to 4 weeks Patients will rinse oral cavity with 10cc of clobetasol 0.05% oral rinse for 2 minutes 3 times a day.
Placebo Comparator: Group 2
Patients will rinse oral cavity with 10cc of placebo oral rinse for 2 minutes 3 times a day.
Drug: Placebo oral rinse
Patients will rinse oral cavity with 10cc of placebo oral rinse for 2 minutes 3 times a day.

Detailed Description:


  • Chronic Graft versus Host Disease (cGVHD) is a major late complication of allogeneic hematopoietic stem cell transplantation.
  • The oral cavity is the second most commonly affected area in cGVHD and is a major cause of morbidity.
  • Clobetasol is a high-potency topical corticosteroid widely used for a variety of inflammatory disorders of the skin and oral mucosa.
  • Treatment of oral cGVHD by topical agents is an attractive strategy to potentially avoid adverse effects associated with systemic immunosuppression.


- To investigate efficacy of topical clobetasol 0.05% oral rinse for oral chronic graftversus-host disease (cGVHD)


- Patients age 12-99 years with clinically significant oral cGVHD.


  • This is a randomized, double blind, placebo-controlled, pilot study of clobetasol 0.05% topical oral rinse with an open label extension period.
  • Patients will rinse oral cavity with 10cc of clobetasol 0.05% or placebo oral rinse for 2 minutes 3 times a day.
  • Treatment duration will be for 2 weeks in the randomized phase and 2-4 weeks in the open label phase.
  • Up to 40 patients will be enrolled on this pilot trial until 34 evaluable patients are assessed.

Ages Eligible for Study:   12 Years to 99 Years   (Child, Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
  • Age: 12 years 99 years.
  • Diagnosis: clinically significant oral cGVHD after allogeneic HSCT with severity score of at least 2 on erythema subset and/or at least 1 on ulceration subset and a composite score greater than or equal to 20 of the Oral Mucositis Rating Scale (OMRS) scale confirmed by the principal investigator (PI), clinical study chair (CSC), or lead associate investigator (LAI).
  • Hematologic Function: Patients must have a platelet count greater than or equal to 20,000/microL at the time of the initial evaluation.
  • Informed Consent: All patients or their legal representative (for patients <18 years old) must sign an IRB approved informed consent document (cGVHD natural history protocol 04-C-0281 or any NCI protocol allowing for screening procedures) prior to performing studies to determine patient eligibility. After confirmation of patient eligibility all patients or their legal representative must sign the protocol specific informed consent. For pediatric patients age appropriate assent will be obtained in accordance with NIH guidelines.
  • Patients must be able to rinse and expectorate study medication rather than swallow it. Female patients must be willing to practice birth control (including abstinence) during and for two months after treatment, if of childbearing potential.
  • Patients must have the ability and willingness to come to Clinical Center for bi-weekly follow-up appointments.
  • No change in systemic immunosuppressive therapy (type or intensity level) within 2 weeks prior to enrollment.
  • A 7-day washout period is required if patients are currently using another oral topical treatment for mouth lesions. Patients currently using clobetasol oral topical treatment are not eligible for this study.


  • Documented hypersensitivity to clobetasol.
  • Use of clobetasol ointment intra-orally at any time during the last 6-month period.
  • Pregnant or breast-feeding females due to possible toxicity to the fetus or infant.
  • Inability to understand the investigational nature of the study to provide informed consent.
  • Patients who, for medical or other reasons, are unable to comply with the study procedures.
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Please refer to this study by its identifier: NCT01557517

United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
National Cancer Institute (NCI)
Principal Investigator: Steven Z Pavletic, M.D. National Cancer Institute (NCI)
  More Information

Additional Information:
Responsible Party: National Cancer Institute (NCI) Identifier: NCT01557517     History of Changes
Other Study ID Numbers: 120068
Study First Received: March 16, 2012
Last Updated: April 20, 2017

Keywords provided by National Institutes of Health Clinical Center (CC):
Oral cGVHD
Oral Rinse
Oral Graft-Versus-Host Disease

Additional relevant MeSH terms:
Graft vs Host Disease
Immune System Diseases
Anti-Inflammatory Agents
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs processed this record on May 22, 2017