Efficacy and safety of topical administration of tacrolimus in oral lichen planus: An updated systematic review and meta‐analysis of randomized controlled trials

Abstract

Background: Symptomatic oral lichen planus is a common chronic T-cell-mediated disorder characterized by pain and inflammation. The meta-analysis aimed to compare and evaluate the effects and safety of tacrolimus for treating patients with symptomatic oral lichen planus.Methods: A comprehensive literature review was performed, including PubMed, the Cochrane Library, Embase, and Web of Science published up to and including December 2020. ClinicalTrials.gov was searched for ongoing trials. There were no restrictions on language or date of publication. Using the Cochrane Collaboration tool, we assessed the risk of bias for randomized controlled trials and estimated the proportion of between-trial heterogeneity.Results: A total of 9 RCTs evaluating the effects of tacrolimus were included in this study. The results revealed no significant difference in clinical resolution and relapse between tacrolimus and corticosteroids. However, tacrolimus may be more likely to cause mild adverse effects. In particular, clinical resolution was not significantly different between tacrolimus and clobetasol propionate, and between tacrolimus and triamcinolone acetonide, while tacrolimus was more likely to cause adverse effects than triamcinolone acetonide and clobetasol propionate. Moreover, there was no significant difference in pain resolution between tacrolimus and clobetasol. Furthermore, adverse effects were not significantly different between tacrolimus and pimecrolimus.Conclusions: This systematic review and meta-analysis of 9 clinical trials supported the short-term application of tacrolimus as an effective regimen in OLP patients resistant to other topical and systemic therapies. Furthermore, the adverse effects of tacrolimus were minor and transient and did not affect tacrolimus' continued application.

Evaluation of muco-adhesive tacrolimus patch on caspase-3 induced apoptosis in oral lichen planus: a randomized clinical trial

“…The previous interpretation was documented in the recent meta-analysis by Zhangci et al ( 2022), which reported that there was no difference in clinical resolutions between tacrolimus and corticosteroids and recommended the use of mucoadhesive carrier systems with a sustained release profile for improving the clinical outcomes [26], which were also demonstrated in our study.…”

Efficacy and Safety of Topical Tacrolimus in Comparison with Topical Corticosteroids, Calcineurin Inhibitors, Retinoids and Placebo in Oral Lichen Planus: An Updated Systematic Review and Meta-Analysis

“…The pooled data from our meta-analysis shows that there is not sufficient evidence to prove that Tacrolimus is better in efficacy than other topical corticosteroids. Our study's findings are consistent with earlier systematic reviews and meta-analyses (Guo et al, 2015;Sridharan et al, 2021;Su et al, 2022).…”

Outcome and long‐term treatment protocol for topical tacrolimus in oral lichen planus

“…[10][11][12][13][14][15][16][17][18][19][20]22,23 The efficacy of topical calcineurin inhibitors in comparison to topical corticosteroids has been examined in four conventional meta-analyses. While three studies concluded that both therapies are similarly effective, 17,18,24 one report indicated that topical tacrolimus is superior compared to topical steroids. 16 In a metaanalysis of multiple interventions, tacrolimus showed the best clinical response and the best symptom-reducing effect when compared to placebo and other topical interventions, while dexamethasone had the best sign-reducing effect and showed the least adverse events.…”