Efficacy of topical hyaluronic acid for symptomatic oral lichen planus: A systematic Review.

Al‐Maweri, Sadeq Ali; Alanazi, Rawan; Alhajj, Mohammed Nasser; Daer, Ammar; Hunaish, Abdulrahman Ahmed; Nabhan, A.; Al-Sosowa, Abeer A

doi:10.17126/joralres.2021.056

Cited by 4 publications

(6 citation statements)

References 21 publications

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“…Two other studies reported an unclear risk of bias in selection/performance/detection [ 13 20 ]. A previous systematic review reported that three out of four studies showed a high risk of bias, while the present study also reported a high risk of bias in five out of seven studies [ 21 ]. Al Maweri et al [ 21 ] followed the CONSORT guidelines to assess the quality and risk of bias of the included studies.…”

Section: Discussionsupporting

confidence: 54%

“…A previous systematic review reported that three out of four studies showed a high risk of bias, while the present study also reported a high risk of bias in five out of seven studies [ 21 ]. Al Maweri et al [ 21 ] followed the CONSORT guidelines to assess the quality and risk of bias of the included studies. The study by Nolan et al [ 14 ] reported low risk, but in our study, we reported some concerns in the quality due to randomization, allocation, and reporting biases based on the Cochrane Risk of Bias tool [ 21 ].…”

Section: Discussionsupporting

confidence: 54%

“…Al Maweri et al [ 21 ] followed the CONSORT guidelines to assess the quality and risk of bias of the included studies. The study by Nolan et al [ 14 ] reported low risk, but in our study, we reported some concerns in the quality due to randomization, allocation, and reporting biases based on the Cochrane Risk of Bias tool [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, despite HA showing promising properties, data for its usage in OLP remain scarce and conflicting [ 6 15 18 19 20 ]. Previous systematic reviews have compared the efficacy of topical HA with only steroids/placebo [ 21 ]. Thus, the aim of this systematic review was to carefully analyze the effectiveness of HA in the management of OLP in comparison with placebo or any other intervention.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

Waingade

Medikeri

Gaikwad

2022

J Dent Anesth Pain Med

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Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

Waingade

Medikeri

Gaikwad

2022

J Dent Anesth Pain Med

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“…Additionally, specific conditions such as pregnant and lactating females, herpetic infections, hypertension, diabetes mellitus, tuberculosis, glaucoma, and Human immunodeficiency virus (HIV) infection contraindicate systemic corticosteroid therapy. Hence, it is imperative to have an altered treatment protocol for OLP [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D in the Treatment of Oral Lichen Planus: A Systematic Review

Saeed

Choudhury²,

Ahmad

et al. 2022

Biomedicines

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Oral lichen planus (OLP) is a chronic mucocutaneous condition that affects up to 2% of the general population, and typically presents with long-standing, non-responsive lesions, with episodes of exacerbation and remissions. The etiopathogenesis of OLP is still unclear, although, it has been postulated that it is most likely a T-cell-mediated condition of an unknown antigen. The treatment remains a challenge with no defined treatment strategy. Vitamin D has anti-inflammatory and immunomodulatory properties, along with its regulatory effect on keratinocyte proliferation and differentiation; thus, suggesting its possible role in the treatment of OLP. This systematic review aims to evaluate the therapeutic role of vitamin D in OLP treatment. We searched PubMed/MEDLINE, and Google scholar search engines for studies evaluating vitamin D as a treatment modality in OLP from January 2000 to August 2022. Articles were searched with the combination of Medical Subject Heading (MeSH) terms. A web platform for visualizing risk-of-bias assessment was used in this review, and descriptive statistics were calculated. Out of the seventeen retrieved studies, five articles meeting the inclusion criteria were considered in this systematic review. All the included studies demonstrated significant amelioration in the OLP symptoms in patients who were given vitamin D supplements as an adjuvant to the conventional steroid therapy and or placebo. This systematic review signifies the role of vitamin D as adjuvant therapy for OLP. However, more studies with larger sample size are required to validate these results.

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The role of vitamin D in amelioration of oral lichen planus and its effect on salivary and tissue IFN-γ level: a randomized clinical trial

Shalaby,

Nawawy,

Selim

et al. 2024

BMC Oral Health

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Background and objectives Oral lichen planus (OLP) is a common, prevalent, immune-mediated, inflammatory disease affecting both the skin and oral mucosa and is considered one of the potentially malignant diseases. Since OLP is regarded as an immunologically mediated disease, some studies suggest the use of vitamin D (VD) for its management as it exhibits immune-modulatory, anti-inflammatory, and antimicrobial properties, as well as anti-proliferative, pro-differentiative, and anti-angiogenic effects. VD has demonstrated a suppressive effect on TH1 pro-inflammatory cytokines, including IFN-γ while augmenting the secretion of anti-inflammatory cytokines. At the same time, VD deficiency is a prevalent public issue. Therefore, the present study aimed to investigate the role of VD as an adjunct to steroids in the management of VD-deficient OLP patients as well as its inhibitory effect on IFN-γ through measurement of salivary and tissue IFN-γ levels in OLP patients. Methods A total of 40 patients with ulcerative or erythematous OLP, diagnosed according to the World Health Organization’s (WHO) modified criteria for OLP, were randomly allocated into one of the two study groups to receive either systemic steroids in addition to VD supplements (Group A) or systemic steroids only (Group B). Blood samples were collected for the measurement of serum VD level (SVDL) using the enzyme-linked immunosorbent assay (ELISA) to involve only patients with VD deficiency or insufficiency (≤ 30 ng/ml). Clinical evaluation of the lesion involved objective signs and subjective symptoms. Also, changes in salivary and tissue INF-γ levels (in pg/mL and pg/mg, respectively) were determined using the ELISA technique. All parameters were measured at baseline and after 4 weeks of treatment. The clinical pharmacy team devised a checklist to record all team interventions. The interventions were categorized into six domains, including drug interactions and/or adverse reactions, medication dose issues, drug selection issues, support with medication history, patient-related concerns, and suggestions for dental medication. Results After one month of treatment, a significantly greater number of patients in group A showed complete pain relief and resolution of clinical lesions, as well as a greater number of patients showing a reduction in the clinical severity of lesions than in group B (P = 0.005). Also, there was a statistically significant reduction in average VAS pain scores and clinical scores in group A compared to group B after 1 month of treatment (P = 0.001 and 0.002, respectively). Furthermore, there was a statistically significant greater reduction in salivary and tissue IFN-γ levels in group A than in group B (P ≤ 0.001 and 0.029, respectively) after 1 month of treatment. Conclusion Current evidence suggests a significant preventive and therapeutic role for VD as an adjunct to standard therapies indicated for OLP lesions. These protective and therapeutic functions are achieved through the suppressive effect of VD on pro-inflammatory cytokines, particularly IFN-γ. Also, salivary IFN-γ appears to be a valuable prognostic marker for monitoring the progression of OLP. In addition, the inter-professional collaboration between dentists and clinical pharmacists helped to deliver complete, patient-centered primary care and ensured the quality of the medications included in patient kits, thus improving patient treatment and management. Nevertheless, further studies with larger sample sizes, longer follow-ups, and standardized designs may still be needed.

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Efficacy of topical hyaluronic acid for symptomatic oral lichen planus: A systematic Review.

Cited by 4 publications

References 21 publications

Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

Vitamin D in the Treatment of Oral Lichen Planus: A Systematic Review

The role of vitamin D in amelioration of oral lichen planus and its effect on salivary and tissue IFN-γ level: a randomized clinical trial

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