Topical pimecrolimus versus betamethasone for oral lichen planus: a randomized clinical trial

Ezzatt, Ola Mohamed; Helmy, Iman M.

doi:10.1007/s00784-018-2519-6

Cited by 20 publications

(26 citation statements)

References 51 publications

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“…Regarding its efficacy, two randomized double‐blind, vehicle‐controlled studies concluded pimecrolimus 1% to be superior to vehicle in reducing pain, erythema, lesional size and overall severity in oral LP . Another randomized, controlled trial comparing pimecrolimus 1% with betamethasone 0.1% has shown that pimecrolimus 1% demonstrates earlier clinical response and less recurrence rate after 4 weeks of therapy . One prospective study concluded pimecrolimus 1% to be superior to topical triamcinolone acetonide 0.1% paste for oral LP …”

Section: Topical Calcineurin Inhibitorsmentioning

confidence: 99%

Lichen planus: a comprehensive evidence‐based analysis of medical treatment

Husein‐ElAhmed

Gieler

Steinhoff

2019

Acad Dermatol Venereol

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Lichen planus (LP) is a chronic-relapsing inflammatory skin disease. Although many drugs have been used for the management of LP, some of them lack the backup by strong therapeutic evidence, while others are not suitable for some patients due to safety profile issues. The aim of this study was to review the recent status of available medical therapies for LP to help physicians make better decisions upon best medical practice while facing patients with this condition. A review of published articles on management of LP was conducted with the MEDLINE and PubMed databases. The quality of the evidence was graded as high, moderate, low or very low. A total of 1366 articles were retrieved, and 219 (16%) were included in the final analysis. Twenty-one different treatment modalities were analysed. The quality of evidence was high for topical steroid and calcineurin inhibitor, while it was moderate for oral steroids. All the other modalities reached low or very low quality of evidence. Topical steroids and calcineurin inhibitors are the current first-line therapies, while for other therapies the strength of recommendation is not so evident. Unfortunately, larger randomized, controlled trials to support the efficacy, safety and tolerability of other therapies in LP are lacking, and many of them are recommended based on studies with small sample sizes, lack of standardized outcome measures or lack of controlled duration or even in anecdotal evidence. Thus, large-scale randomized clinical trials are still warranted to establish the exact benefits of other topical treatments, phototherapy, immunosuppressant and new immunomodulators for an optimized treatment of LP.

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Section: Topical Calcineurin Inhibitorsmentioning

confidence: 99%

Lichen planus: a comprehensive evidence‐based analysis of medical treatment

Husein‐ElAhmed

Gieler

Steinhoff

2019

Acad Dermatol Venereol

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“…Vehicle 5 Betamethasone valerate 0.1% cream 6 Pimecrolimus was found to be more effective than vehicle, but less effective than betamethasone. Oral erosive lichen planus Vehicle [7][8][9][10] Triamcinolone acetonide 0.1% paste 11 Betamethasone valerate 0.1% cream 12 Tacrolimus 0.1% ointment 13,14 Pimecrolimus was found to be more effective than vehicle, and similarly effective as topical corticosteroids and tacrolimus. A smaller proportion of patients treated with pimecrolimus required retreatment.…”

Section: Intertriginous Psoriasismentioning

confidence: 97%

Off-label Uses of Topical Pimecrolimus

et al. 2019

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Pimecrolimus is a topical calcineurin inhibitor currently approved for second-line use in the management of mild-to-moderate atopic dermatitis in patients age 2 years and older. Given the safety profile and nonsteroidal mechanism of pimecrolimus, there has been significant interest in its use in the treatment of a variety of dermatological conditions. This article reviews research that has been published on the off-label uses of topical pimecrolimus, with a focus on published RCTs. Convincing evidence exists supporting pimecrolimus’ efficacy in oral lichen planus and seborrheic dermatitis. For other conditions studied to date, pimecrolimus may prove to be a useful treatment alternative when conventional agents fail. Adverse events seen with its off-label use were typically application site reactions, the most common being a transient burning sensation. In summary, pimecrolimus appears to be an effective agent in the treatment of multiple dermatological conditions and may be worth considering as a pharmacologic alternative in several conditions when first-line treatment fails, or for areas that are more susceptible to the adverse effects of topical corticosteroids.

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“…OLP is a T cell‐mediated chronic inflammatory disease targeting the basal keratinocytes . CD4 helper T cells are activated by an unknown antigen, which secrets cytokines and interleukins that recruit Langerhans and CD8 cytotoxic T cells .…”

mentioning

confidence: 99%

“…CD4 helper T cells are activated by an unknown antigen, which secrets cytokines and interleukins that recruit Langerhans and CD8 cytotoxic T cells . Cytotoxic T cells trigger apoptosis of the basal cells (target cells) …”

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical Management Protocol for Dental Implants Inserted in Patients with Active Lichen Planus. Part II 4‐Year Follow‐Up

Khamis

Aboushelib

Helal

2018

Journal of Prosthodontics

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Purpose: To evaluate marginal bone loss (MBL) of dental implants inserted in active lichen planus patients. Materials and Methods:The study included 59 subjects divided into 3 groups depending on their lichen planus diagnosis and administration of a low dose of corticosteroids: 17 healthy individuals, 20 controlled lichen planus patients controlled using low doses of systemic corticosteroids, and 22 noncontrolled lichen planus patients. During 4-year follow-up sessions MBL was evaluated, and biopsies were collected from lichen planus patients and examined. Two-way ANOVA was used to analyze the data (α = 0.05).

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Topical pimecrolimus versus betamethasone for oral lichen planus: a randomized clinical trial

Abstract: The study proved the benefits of topical pimecrolimus in early management of painful lesions of OLP and its ability to inhibit CSCs, suggesting a possible role in reducing risk of malignant transformation.

Cited by 20 publications

References 51 publications

Lichen planus: a comprehensive evidence‐based analysis of medical treatment

Lichen planus: a comprehensive evidence‐based analysis of medical treatment

Off-label Uses of Topical Pimecrolimus

Clinical Management Protocol for Dental Implants Inserted in Patients with Active Lichen Planus. Part II 4‐Year Follow‐Up

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