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

Area of Science:

• Oral medicine
• Dermatology
• Pharmacology

Background:

• Oral lichen planus (OLP) is a chronic inflammatory condition affecting oral mucosa.
• Various treatments including corticosteroids, calcineurin inhibitors, and herbal drugs have been explored for OLP.
• A comparative analysis of these interventions is crucial for evidence-based practice.

Purpose of the Study:

• To conduct a network meta-analysis comparing different interventions for symptomatic oral lichen planus.
• To evaluate the efficacy and safety of various treatment options based on existing clinical trials.

Main Methods:

• Systematic search of electronic databases for randomized clinical trials on OLP interventions.
• Inclusion of 55 trials involving 2831 patients.
• Evaluation of outcomes including clinical resolution, clinical score, pain resolution, pain score, and adverse effects.

Main Results:

• Corticosteroids, pimecrolimus, purslane, and ozonized water/corticosteroids showed significantly better clinical resolution than placebo.
• Corticosteroids, ozonized water/corticosteroids, aloe vera, pimecrolimus, and hyaluronic acid were associated with superior pain resolution.
• Pimecrolimus and cyclosporine use was linked to a higher risk of adverse effects.

Conclusions:

• Topical corticosteroids emerge as the most effective drug class for treating oral lichen planus.
• Several other interventions demonstrate potential benefits for OLP symptom management.
• Further research may be needed to fully elucidate the risk-benefit profiles of all evaluated treatments.