Randomized Trial of Pimecrolimus Cream plus Colchicine Tablets versus Colchicine Tablets in the Treatment of Genital Ulcers in Behcet's Disease

Background: Recurrent and painful genital ulcers are the hallmark of Behcet's disease. Objective: To determine the efficacy of pimecrolimus (PIM) cream on the pain and healing time of genital ulcers. Methods: A total of 76 patients were randomized to either receive PIM cream plus colchicine (COL) tablets (1-2 g/day) or COL tablets (1-2 g/day) alone for 1 month. Clinical evaluations were performed in 68 patients at the baseline and on the 3rd, 7th, 10th, 14th and 28th days of treatment. Also, genital ulcer pain was evaluated using a verbal pain score at each visit. Safety was monitored through adverse event reporting and laboratory tests. Results: The mean healing time of genital ulcers was shorter in the PIM + COL group (4.2 +/- 1.5 days) than the COL group (4.7 +/- 1.8 days), without statistical significance (p = 0.399). Visual analog scale scores decreased in both groups significantly. Neither of the treatment modalities was found to be superior to the other; however, pain was relieved in 4.2 +/- 0.5 days in PIM + COL group and in 5.5 +/- 1.2 days in COL group in the intention to treat population (p = 0.023). Observed adverse events were transient. Conclusion: Compared to COL alone, COL + PIM cream shortens the pain duration without any significant effect on healing time. Copyright (C) 2008 S. Karger AG, Basel