Treatment of Chronic Erosive Oral Lichen Planus With Low Concentrations of Topical Tacrolimus

Olivier, Valérie; Lacour, Jean‐Philippe; Mousnier, Aline; Garraffo, R.; Monteil, R; Ortonne, Jean-Paul

doi:10.1001/archderm.138.10.1335

Cited by 119 publications

(88 citation statements)

References 19 publications

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“…However, the chronic nature of the autoimmune mucocutaneous diseases that are often associated with DG might require long-term (6-12 weeks) use of topical tacrolimus, which could be associated with immunosuppressant toxicity, including malignancy. 7,8,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]35,36 The specific cause (ie, oral lichen planus, pemphigoid) of DG was not determined in the 24 patients in this study.…”

Section: Discussionmentioning

confidence: 99%

“…4,6 Topical tacrolimus at concentrations of 0.03%, 0.1%, and 0.3% has been associated with efficacy and tolerability in the treatment of inflammatory skin diseases 12-22 and has been used for oral diseases associated with autoimmune dermatoses. 7,8,[23][24][25] Moreover, studies 19,2° have found that the serum metabolites of tacrolimus were undetectable when the drug was used topically. The drug inhibits the activity of calcineurin, an important intracellular phosphatase and, thereby, T-lymphocyte activation.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of topical tacrolimus 0.1 % in pectin ointment with clobetasol 0.5% ointment in adults with moderate to severe desquamative gingivitis: A 4-week, randomized, double-blind clinical trial

Corrocher

Lorenzo

Mansueto

et al. 2006

Clinical Therapeutics

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Background: Desquamative gingivitis (DG) is a clinical condition characterized by red, painful, glazed, and friable gingiva, which might be a manifestation of some autoimmune mucocutaneous diseases. The time from the development of initial signs of DG to diagnosis can vary from months to years. Based on a literature search, no data concerning patients with DG without signs of autoimmune disease were available.Objective: The aim of this trial was to compare the efficacy and tolerability of monotherapy with topical tacrolimus 0.1% in pectin ointment versus clobetasol propionate 0.5% ointment in adults affected by DG.Methods: This randomized, double-blind clinical trial was conducted at the Dipartimento di Medicina Clinica e Sperimentale, Universitfi di Verona, Verona, Italy. Patients aged >18 years were selected using the department's electronic medical records based on a clinical diagnosis of moderate to severe DG. After a 2-week washout period, patients were randomly assigned to receive 2 mL of tacrolimus 0.1% in pectin (equivalent to 0.2 mg of tacrolimus) or 2 mL of clobetasol propionate 0.5% ointment (equivalent to 1 mg of clobetasol) QD for 4 weeks. Evaluations were performed before treatment (baseline), after the treatment period (week 4), and at 2 follow-up visits at weeks 6 and 8. The signs of DG (ie, erythema [atrophy] and desquamation [erosions/ulceration]) were quantified by a blinded investigator using a calculated score based on their surface extension, using a drawing in which the areas of various zones of the mouth were indicated as a percentage of the whole oral mucosa. Severity of erythema and desquamation was rated on a 4-point scale (0 = absent; 1 = involvement of <5% of surface [mild]; 2 = 5%-15% [moderate]; and 3 = >15% [severe]). The primary end point was the number of patients who achieved remission (severity score of 0) in either sign; the secondary end point was the proportions of patients achieving improvement (severity score of 0 or 1) in either sign. Before and after treatment, we measured the serum concentrations of tacrolimus and its metabolites with an immunoenzymatic assay kit. Tolerability was assessed using hematology, biochemistry, urinalysis, measurements of systolic/ diastolic blood pressure and heart rate, patient interview, and spontaneous reporting.Results: A total of 24 patients (18 women, 6 men; all white of Italian origin; age range, 21-65 years; 12 patients per treatment group) were enrolled in the study. In the tacrolimus group, 11 (91.7%) patients achieved remission of erythema and/or desquamation at weeks 4 and 6; at week 8, these rates were 9 (75.0%) and 8 (66.7%), respectively; none of the patients in the clobetasol group achieved remission of either sign at any time point (all, P < 0.001). At weeks 4, 6, and 8, significantly greater proportions of patients treated Accepted for publication September 13, 2006. 1296Volume 28 Number 9 G. Corrocher et al.with tacrolimus had improved erythema and desquamation compared with those treated with clobetasol (all...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of topical tacrolimus 0.1 % in pectin ointment with clobetasol 0.5% ointment in adults with moderate to severe desquamative gingivitis: A 4-week, randomized, double-blind clinical trial

Corrocher

Lorenzo

Mansueto

et al. 2006

Clinical Therapeutics

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“…L'utilisation de bains de bouche de tacrolimus avec des comprimés de Prograf® a été proposée dans le traitement du lichen plan et montrent une efficacité rapide et importante malgré la faible concentration utilisée par rapport à la celle de la pommade (0,005 mg/mL versus 0,3 à 1 mg/g) [16][17][18]. Les effets secondaires sont mineurs (picotements, irritations) et s'atténuent ou disparaissent habituellement en quelques jours [17].…”

Section: Discussionunclassified

Étude rétrospective de l’efficacité du Protopic® (tacrolimus) dans le traitement de la langue géographique algique

Haddad¹,

Boralévi

Catros³

et al. 2015

Med Buccale Chir Buccale

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Résumé -Introduction :La langue géographique (LG) est le plus souvent asymptomatique. Quand elle est douloureuse, le traitement est mal codifié. L'objectif de cette étude est d'évaluer l'efficacité du tacrolimus topique appliqué sur les LG algiques. Matériels et méthodes : Il s'agit d'une étude de cohorte descriptive, rétrospective, menée dans le service d'odontologie du CHU de Bordeaux de janvier 2012 à novembre 2013. Les patients sont traités par tacrolimus 0,1 % en application locale 2 fois par jour pendant 1 mois. Le critère de jugement principal est une évaluation de la douleur avec une échelle numérique verbale (ENV) de 0 à 10 à J0 et à 1 mois. Résultats : Trente et un patients ont consulté pour une langue géographique (LG). Sur ces 31 patients, 17 avaient des brûlures de la langue. Sur ces 17, 12 avaient une douleur imputable à la LG. Sur ces 12, 10 ont été traités par tacrolimus. Lors de la consultation initiale, l'ENV était de 5,9 +/-1,87. L'évaluation à un mois a montré une amélioration significative de l'ENV, 1,6 +/-1,5 (p < 0,001). Aucun événement indésirable grave n'est rapporté, seule une douleur oesophagienne est mentionnée chez trois patients. Conclusion : L'utilisation du tacrolimus topique semble efficace et bien tolérée dans l'indication d'une LG algique. Cependant, un essai randomisé versus placebo serait nécessaire afin de pouvoir conclure avec certitude. Abstract -Introduction:Geographic tongue is usually an asymptomatic disorder. There is no symptomatic treatment evaluated with clinical trials. Our objective was to evaluate the efficiency of tacrolimus in painful Geographic Tongue (GT). Methods: A retrospective descriptive cohort study was performed in the Department of Odontology PQR at the CHU in Bordeaux from January 2012 to November 2013. Patients with painful GT were treated with 0.1% tacrolimus (Protopic) topically twice a day for one month. The primary endpoint was the evaluation of pain with a numerical pain scale (NPS) from 0 to 10 the first day and one month later. The secondary endpoints were the improvement of the quality of life and of eating . Results: Thirty-one patients with GT consulted during the period studied. Seventeen had a burned tongue sensation, five patients presented primitive glossodynia and twelve had painful GT. Ten patients were treated with tacrolimus topically. The average value of the NPS was 5,9 (+/-1.87) at the first consultation. The GT lesions were present in all cases. Eating difficulties or a burned tongue sensation were described by patients. The evaluation one month after the prescription of Protopic showed a significant improvement of the NPS, with an average of 1,6 (+/-1.5) (t-test, p<0.001%). An improvement of the quality of life was noted for all patients. No serious adverse events were reported except esophagus pain for three patients. Conclusions: The utilization of topical tacrolimus seems to be efficient and well-tolerated in painful GT. However, randomized trials versus placebo are necessary to conclude with certitude.

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“…11 Several studies have documented this agent efficacy and safety (at a concentration of 0.03% to 0.1%) in the erosive OLP evolution. 13,49,50,51 However, tacrolimus therapeutic levels in OLP patients have been associated with oral absorption after topical application, leading to systemic side effects. 53,54 In addition, OLP relapses after tacrolimus discontinuation are common.…”

Section: Corticosteroids and Other Treatmentsmentioning

confidence: 99%

“…53,54 In addition, OLP relapses after tacrolimus discontinuation are common. 13,50 Pimecrolimus is another calcineurin inhibitor used in OLP treatment. Its action is similar to tacrolimus, but it has no effect on the Langerhans cells.…”

Section: Corticosteroids and Other Treatmentsmentioning

confidence: 99%

Oral lichen planus: A look from diagnosis to treatment.

Córdova¹,

Rubio²,

Echeverría³

2013

Joralres

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Treatment of Chronic Erosive Oral Lichen Planus With Low Concentrations of Topical Tacrolimus

Cited by 119 publications

References 19 publications

Comparison of topical tacrolimus 0.1 % in pectin ointment with clobetasol 0.5% ointment in adults with moderate to severe desquamative gingivitis: A 4-week, randomized, double-blind clinical trial

Comparison of topical tacrolimus 0.1 % in pectin ointment with clobetasol 0.5% ointment in adults with moderate to severe desquamative gingivitis: A 4-week, randomized, double-blind clinical trial

Étude rétrospective de l’efficacité du Protopic® (tacrolimus) dans le traitement de la langue géographique algique

Oral lichen planus: A look from diagnosis to treatment.

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