Evaluating the efficacy of pentoxifylline in the treatment of oral submucous fibrosis: A meta‐analysis

Abstract

Oral submucous fibrosis (OSMF), a potentially malignant oral cavity disorder that causes speech and mastication problems, lacks an established treatment regimen; moreover, no treatment can effectively reverse the course of OSMF. A meta-analysis was conducted to investigate the efficacy of the peripheral vasodilator, pentoxifylline, in the treatment of OSMF. We searched five different databases for studies meeting our eligibility criteria (up to June 30, 2017). Statistical analyses were performed using RevMan 5.3 software. Three randomized controlled trials (247 OSMF patients) were selected. Pentoxifylline increased the objective sign maximal mouth opening (MMO; WMD: -4.59, 95% CI: -8.65, -0.53; p < 0.05) following short-term (under 1 month; WMD: -1.94, 95% CI: -3.12, -0.77; p < 0.05) and long-term (over 1 month; WMD: -5.44, 95% CI: -6.81, -4.07; p < 0.05) application. Pentoxifylline improved the subjective symptom burning sensation (WMD: -0.11, 95% CI: -0.17, -0.05; p < 0.05) only following long-term application (WMD: 0.42, 95% CI: 0.18, 0.96; p < 0.05). The efficacy on MMO and burning sensation increased with time. Although OSMF lacks definitive treatment modalities, our meta-analysis shows that pentoxifylline effectively improves the objective signs and subjective symptoms of OSMF and its therapeutic efficacy increases with time.

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

“…The drugs used in the control groups have been verified to be effective in the management of OSF by systematic reviews and meta-analyses (pentoxifylline, aloe vera and curcumin [30][31][32] ) and through clinical trials (lycopene, isoxsuprine and dexamethasone 15,33,34 ).…”

“…The drugs used in the control groups have been verified to be effective in the management of OSF by systematic reviews and meta‐analyses (pentoxifylline, aloe vera and curcumin 30‐32 ) and through clinical trials (lycopene, isoxsuprine and dexamethasone 15,33,34 ). Additionally, the current study showed that hyaluronidase combined with corticosteroids was significantly more effective than placebo in alleviating the burning sensation and improving mouth opening in the management of OSF 15 …”

Oral Submucous Fibrosis: A Review on Etiopathogenesis, Diagnosis, and Therapy

“…Dexamethasone Anti-inflammation (block the action of inflammatory mediators) [119,159] Methylprednisolone Anti-inflammation (block the action of inflammatory mediators) [119] Betamethasone Anti-inflammation (block the action of inflammatory mediators) [120] Hyaluronidase Hydrolyze the hyaluronan [121] Chymotrypsin Hydrolyze the collagen [122] Pentoxifylline Anti-inflammation. Inhibits TNF-α and leukotriene synthesis [123,160] Colchicine Anti-inflammation, neutralized cytokines (TGF-β, IL4, IL6) Increase collagenolytic activity [126] Natural compounds remedies Molecular Targets References…”

Aloe vera in treatment of oral submucous fibrosis: A systematic review and meta‐analysis

“…The current evidence suggests that betel quid chewing is the main causative agent for OSF, although the exact pathogenesis of the disease is still not fully understood . The treatment of OSF is challenging, and as yet there is no definitive cure . Many proposed treatment approaches have been currently in use and aiming basically to alleviate the disease's signs and symptoms, to stop disease progression, and to decrease the risk for malignant transformation.…”

“…These approaches include cessation of betel quid use, physiotherapy, medical interventions, and, for advanced cases surgical interventions . Antioxidants, dietary supplements, immunomodulatory therapy, anti‐inflammatory agents (mainly corticosteroids), fibrinolytic agents, and peripheral vasodilators have been used for management of OSF …”