Interventions for treating oral lichen planus: corticosteroid therapies

Area of Science:

• Oral medicine
• Dermatology
• Immunology

Background:

• Oral lichen planus (OLP) is a chronic T cell-mediated condition causing pain, especially in erosive forms.
• Pain relief is the primary treatment goal for OLP.
• This review updates previous findings, focusing solely on corticosteroid treatments for OLP.

Purpose of the Study:

• To evaluate the effectiveness and safety of corticosteroid treatments for symptomatic oral lichen planus.
• To compare corticosteroids with placebo, calcineurin inhibitors, and other treatments.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases up to February 2019 without language or publication date restrictions.
• Included 35 RCTs with 1474 participants, assessing pain, clinical resolution, and adverse effects using GRADE criteria.

Main Results:

• Low-certainty evidence suggests topical corticosteroids may be more effective than placebo for pain resolution in OLP.
• Results for clinical resolution and adverse effects were inconclusive for corticosteroids versus placebo.
• Very low-certainty evidence indicates calcineurin inhibitors (tacrolimus) may offer better pain relief than corticosteroids, with uncertain findings on clinical response and adverse effects.

Conclusions:

• Topical corticosteroids may offer some pain relief for OLP, but evidence quality is low.
• Calcineurin inhibitors, particularly tacrolimus, show potential for superior pain relief compared to corticosteroids.
• Further high-quality research is necessary to clarify the comparative efficacy and safety of OLP treatments.