Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials

Sridharan, Kannan; Sivaramakrishnan, Gowri

doi:10.1111/adj.12835

Cited by 32 publications

(38 citation statements)

References 58 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some reviews 33,34 pooled the data of tacrolimus in topical or gargle preparations together, with possible heterogeneity. Some reviews 35,37 pooled the data of topical or systemic drugs together, and review included a few studies with no binding, which may have affected the pooled results. Both studies 33,35 did not explore differences between the individual corticosteroid drug and tacrolimus.…”

Section: Relapsementioning

confidence: 99%

“…Similarly, two previous reviews 33,34 suggested that no difference in the efficacy was noted between tacrolimus and corticosteroids. However, one meta-analysis 35 concluded that topical corticosteroids are the most useful agents for the treatment of OLP, whereas two other studies 36,37 demonstrated that tacrolimus was more effective than corticosteroids. Importantly, the inclusion criteria of previous reviews were different from our review.…”

Section: Relapsementioning

confidence: 99%

See 1 more Smart Citation

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

Cheng

et al. 2021

J Oral Pathology Medicine

View full text Add to dashboard Cite

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.

show abstract

Section: Relapsementioning

confidence: 99%

Section: Relapsementioning

confidence: 99%

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

Cheng

et al. 2021

J Oral Pathology Medicine

View full text Add to dashboard Cite

show abstract

“…We identified 26 citations of which 10 systematic reviews (Albedah et al, 2013;Azarpazhooh & Limeback, 2008;Brazzelli et al, 2006;Deepthi & Bilichodmath, 2020;German et al, 2013;Moraschini et al, 2020;Santos et al, 2020;Sharda et al, 2021;Silva et al, 2020;Sridharan & Sivaramakrishnan, 2021) and 16 narrative reviews (Almaz & Sönmez, 2015;Chirumbolo et al, 2021;Domb, 2019;Gupta & Mansi, 2012;Haghighat & Oshaghi, 2020;Lacerda et al, 2021;Lio et al, 2020;Mohammadi et al, 2013;Nogales et al, 2008;Re et al, 2020;Seidler et al, 2008;Suh et al, 2019;Swanson et al, 2021;Tiwari et al, 2017;Trevor Burke, 2012;Tricarico et al, 2020); met the criteria for inclusion in the Map. Most of the reviews were published in the 2008, 2012 and 2014.…”

Section: Resultsmentioning

confidence: 99%

Experience with the evidence map in oral ozone therapy - importance for integrative and complementary health practices

Cordon

Laganá

Traina

et al. 2021

RSD

View full text Add to dashboard Cite

medical and dental treatment in the form of ozonized water and oxygen / ozone gas mixture and associated with photobiomodulation therapy. The evidence map was based on the 3iE evidence searched in the databases: LILACS, PubMed, EMBASE and Cochrane Library, seeking systematic and narrative reviews, analyzed in an excel characterization spreadsheet. Three independent literature reviewers screened the systematic review search output blinded at the software Rayyan. The full-text publications were screened against the specified inclusion criteria by thre independent reviewers; disagreements were resolved through discussion. Forty-two studies were found, 16 of which were systematic reviews and 26 narrative reviews, published between 2006 and 2021, with different levels of confidence. The intervention that most appeared in the literature was oral ozone therapy as a bacterial colony reduction and decontamination agent, with emphasis on topical oxygen-ozone gas mixtures, topical ozonized water. Oral ozone therapy can bring benefits to clinical practice and patients. The evidence map provides an easy visualization of valuable information for patients, health practitioners and managers, in order to promote evidence-based complementary therapies.

show abstract

“…Topical corticosteroids are generally considered as first line treatment for the management of symptomatic OLP ( 11 - 13 ). On the other hand, cyclosporine has been investigated as an alternative topical agent for the management of OLP ( 16 , 26 - 45 ).…”

Section: Introductionmentioning

confidence: 99%

A randomized clinical trial of topical dexamethasone vs. cyclosporine treatment for oral lichen planus

Georgaki¹,

Piperi²,

Theofilou³

et al. 2022

Med Oral

View full text Add to dashboard Cite

Background Oral lichen planus (OLP) is a common, frequently symptomatic, immune-mediated disease. Various treatments have been used for symptomatic OLP, including corticosteroids and immunosuppressants administered topically or systemically. The aim of this study was to compare the effectiveness of topical dexamethasone vs. topical cyclosporine in treatment of symptomatic OLP. Material and Methods Thirty-two patients with biopsy-proven symptomatic OLP were randomly assigned to two therapeutic groups: dexamethasone 2mg/5ml or cyclosporine 100mg/ml, both administered topically in a swish and spit method three times a day for 4 weeks. The patients were followed up for a total of 6 months. Assessed parameters included clinical scoring (according to Thongprasom’s scale, 0-5), pain (VAS scale, 0-10), dysphagia and speech difficulties (none, mild or severe). Possible side effects, including fungal overgrowth, were also recorded. Results At the end of the 4-week treatment period, both dexamethasone and cyclosporine showed a statistically significant improvement in clinical scoring ( p <0.025 and p =0.034, respectively), which was better with dexamethasone ( p =0.001). In addition, both dexamethasone and cyclosporine induced statistical significant improvement in pain and dysphagia (and speech difficulties for dexamethasone), without significant differences between the two groups. Regarding side effects, patients in the dexamethasone group developed candidiasis more frequently compared to cyclosporine ( p =0.031). At the end of the 6-month follow-up period, the difference in response between the two groups was not statistically significant. Interestingly, a trend for further improvement compared with the end of the 4-week treatment period was noticed only for patients treated with cyclosporine. Conclusions Despite the small number of enrolled patients, topical cyclosporine treatment induces a significant clinical improvement in symptomatic OLP patients, which, compared to topical dexamethasone, appears to be less pronounced during initial administration, but capable to induce further improvement after discontinuation with a satisfactory long-term remission in the absence of significant side effects. This study may contribute to a better understanding of the differences in effectiveness of OLP topical treatments and guide future larger scale clinical trials. Key words: Oral lichen planus, topical treatment, dexamethasone, cyclosporine.

show abstract

Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials

Cited by 32 publications

References 58 publications

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

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

Experience with the evidence map in oral ozone therapy - importance for integrative and complementary health practices

A randomized clinical trial of topical dexamethasone vs. cyclosporine treatment for oral lichen planus

Contact Info

Product

Resources

About