Efficacy of hyaluronidase combined with corticosteroids in treatment of oral submucous fibrosis: A meta‐analysis of randomized controlled clinical trials

Abstract

Objective: This meta-analysis was performed to systematically evaluate the efficacy of hyaluronidase combined with corticosteroids compared with other drugs in improving maximum mouth opening and alleviating the burning sensation in patients with oral submucous fibrosis (OSF). Methods:PubMed, Embase, Web of Science and the Cochrane Library were searched.RevMan 5.3 software was used for the meta-analysis.Results: Six studies involving 244 patients with OSF were analysed. No significant difference in improvement of maximum mouth opening was found between the hyaluronidase and control groups (lycopene, pentoxifylline, aloe vera, dexamethasone, Turmix [curcumin + piperine] and isoxsuprine) at 1 month (mean difference [MD]: 0.32, 95% confidence interval [CI]: −0.92-1.56, P = .61, I 2 = 57%), 2 months (MD: 0.49, 95% CI: −0.14-1.12, P = .12, I 2 = 41%) or 3 months (MD: 0.40, 95% CI: −1.08-1.87, P = .60, I 2 = 92%). Additionally, no statistically significant difference was found in alleviation of the burning sensation between the two groups at 1 month (MD: 0.54, 95% CI: −0.62-1.71, P = .36, I 2 = 0%), 2 months (MD: 0.53, 95% CI: −0.85-1.91, P = .45, I 2 = 0%) or 3 months (MD: 0.64, 95% CI: −1.07 to 2.35, P = .46, I 2 = 0%). Conclusions:According to this meta-analysis, weak evidence indicates that hyaluronidase combined with corticosteroids has no additional clinical benefit over control drugs (lycopene, pentoxifylline, aloe vera, dexamethasone, Turmix and isoxsuprine) in improving maximum mouth opening and alleviating the burning sensation in patients with OSF. Therefore, more high-quality, multi-centre randomized controlled trials with larger samples are needed to further assess the efficacy of hyaluronidase combined with corticosteroids in the treatment of OSF. K E Y W O R D Shyaluronidase, meta-analysis, oral submucous fibrosis

Significantly higher serum tumor marker levels in patients with oral submucous fibrosis

“…Several treatment modalities for OSF have been proposed, including surgical intervention, medical treatments, and physiotherapy but there is lack of an effective way for treatment of OSF so far. 11 , 12 , 13 , 14 , 15 Thus, early diagnosis of OSF is pivotal for prevention of occurrence of OSF.…”

Drug treatment for oral submucous fibrosis: a systematic review

“…Therefore, a combination of curcumin, triamcinolone acetonide, and hyaluronidase is recommended as hyaluronidase facilitates deeper administration of curcumin and triamcinolone acetonide, which have synergistic effects between each other. A meta-analysis by Guo et al [35] showed that compared with placebo, oral curcumin signi cantly improved the symptoms of MMO and burning sensation. Compared with lycopene and other drugs, curcumin was less effective in improving mouth opening after 1 month of treatment, and the improvement of burning sensation after 3 months of treatment was better than that in the control group.…”

Exploring the Impact of Climatic Variables on Arecanut Fruit Rot Epidemic by Understanding the Disease Dynamics in Relation to Space and Time

“…Estimation of disease was done on randomly chosen and tagged fallen nuts palm (n = 50) across the 18 weeks and then converted into the PDI. The PDI of fruit ro arecanut was determined by the standard Formula (1) and disease rating scale (1)(2)(3)(4)(5)(6) veloped by Sastry and Hegde [31] as shown in Table 2.…”

“…Arecanut is majorly grown in the southern and northeastern parts of the country, which includes Karnataka, Kerala, Tamil Nadu, West Bengal and Assam, which shares 90% of the total area and production [ 5 ]. Although the arecanut production is restricted to a few states, the major industrial products are globally shared, and about 700 million consume arecanuts world-wide [ 6 , 7 ]. India contributes about 57% of the global arecanut production and the remaining 43% was shared among China, Bangladesh, Myanmar and other countries.…”