Betamethasone oral mini-pulse therapy compared with topical triamcinolone acetonide (0.1%) paste in oral lichen planus: A randomized comparative study

Malhotra, Amber; Khaitan, Binod K.; Sethuraman, Gomathy; Sharma, Vinod

doi:10.1016/j.jaad.2007.11.022

Cited by 81 publications

(80 citation statements)

References 12 publications

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“…One study [14] was a multicentre study. The diagnosis of OLP was confirmed clinically in all studies and histologically in all but one [20]. [18] all the participants received a systemic steroid, and in another study [28] the experimental intervention was compared with intralesional steroid.…”

Section: Study Characteristicsmentioning

confidence: 82%

“…Among these studies, [4,8,9,27,36] did not present any significant difference in pain reduction. However, lower pain scores in the group that used microsphere formulation [10] & better response in betamethasone group [20] were shown.…”

Section: Steroid Vs Steroidmentioning

confidence: 87%

“…[18] all the participants received a systemic steroid, and in another study [28] the experimental intervention was compared with intralesional steroid. Of the 29 trials using steroid as an active intervention, clobetasol was used in nine trials [4,7,10,11,19,22,23,27,35], triamcinolone in ten trials [4,5,[13][14][15][16]20,28,31,36], flucinolone in two trials [6,8], dexamethasone in two trials [29,34], prednisolone in one trial [18], fluticasone in one trial [9] & betamethasone in two trials [9,20]. Systemic prednisolone was used in one trial [18].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Pain was reported as a continuous outcome using visual analogue scales (VAS) of different lengths in all trials, except five trials [3,17,22,20,35]. Eisen measured global symptom scores on an ordinal scale of 0 to 3 [3].…”

Section: Outcomes Primarymentioning

confidence: 99%

“…The comparisons were: flucinoloneacetonide in an oral base 0.1% vs flucinoloneacetonide gel no.1 and the same orabase with flucinoloneacetonide gel no.2 [8], clobetasol (0.025%) in microspheres with clobetasol ointment (0.025%) [10], triamcinolone acetonide in mouth rinse vs intralesional triamcinolone acetonide injection [36]; two studies compared different steroids in different arms topical fluticasone propionate spray and betamethasone sodium phosphate mouthrinse [9]; betamethasone OMP and triamcinolone acetonide paste [20]; one trial [4] compared different steroids in the same arm (clobetasolorabase ointment and triamcinoloneacetonide ointment); one study [27] used the same steroid clobetasol ointment in different concentrations (0.05% vs 0.025%). Among these studies, [4,8,9,27,36] did not present any significant difference in pain reduction.…”

Section: Steroid Vs Steroidmentioning

confidence: 99%

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Medical Management of Oral Lichen Planus: A Systematic Review

Suresh

Krunal²,

Desai³

et al. 2016

JCDR

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Section: Study Characteristicsmentioning

confidence: 82%

Section: Steroid Vs Steroidmentioning

confidence: 87%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Outcomes Primarymentioning

confidence: 99%

Section: Steroid Vs Steroidmentioning

confidence: 99%

See 3 more Smart Citations

Medical Management of Oral Lichen Planus: A Systematic Review

Suresh

Krunal²,

Desai³

et al. 2016

JCDR

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Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus

Vinay,

Kumar,

Dev

et al. 2024

JAMA Dermatol

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ImportanceSymptomatic oral lichen planus (OLP) can be challenging to treat.ObjectiveTo compare the efficacy of oral acitretin plus topical triamcinolone acetonide (TAC), 0.1%, with TAC monotherapy in patients with symptomatic OLP.Design, Setting, and ParticipantsThis monocentric, investigator-initiated, placebo-controlled, investigator- and patient-blinded randomized clinical trial was conducted from December 2018 to June 2020 at the Postgraduate Institute of Medical Education and Research, a tertiary referral center in Chandigarh, India. Sixty-four patients 18 years or older with symptomatic OLP were recruited by consecutive sampling. Data were analyzed from July to December 2020.InterventionThe patients were randomized to receive either a combination of oral acitretin (25-35 mg/d) and TAC (treatment group) or TAC in combination with placebo (placebo group) for 28 weeks, with an additional 8 weeks of treatment-free follow-up after the end of treatment (36 weeks of total study duration).Main Outcomes and MeasuresThe disease severity and treatment response were assessed using Oral Disease Severity Score (ODSS), Oral Health Impact Profile 14 (OHIP-14), and visual analog scale (VAS). The primary aim was to assess the number of patients achieving ODSS-75 (75% reduction in ODSS compared with baseline) in both groups at 28 weeks and at the end of 36 weeks.ResultsAmong 64 patients, 31 in the treatment group and 30 in the placebo group completed the study (mean [SD] age, 50.6 [15.2] years vs 49.2 [14.4] years; male-female ratio, 13:19 vs 16:16). Baseline ODSS, visual analog scale, and Oral Health Impact Profile 14 scores were comparable in both groups. In the intention-to-treat analysis, there was a statistically significant higher number of patients achieving 75% or higher reduction in ODSS in the treatment group compared with the placebo group at the end of 28 weeks (28 [88%] vs 15 [47%], a 41 [95% CI, 20-61] percentage point difference between groups; P &lt; .001; Cramér V = 0.47) and 36 weeks (27 [84%] vs 13 [41%], a 43 [95% CI, 23-67] percentage point difference between groups; P &lt; .001; Cramér V = 0.47). Relapses during the posttreatment follow-up of 8 weeks were low among patients in both treatment and placebo groups (1 [3%] vs 2 [6%], a 3 [95% CI, −13 to 7] percentage point difference between groups; P &gt; .99; Cramér V = 0.07).Conclusion and RelevanceIn this randomized clinical trial, the combination of oral acitretin and TAC was more effective than TAC monotherapy in patients with symptomatic OLP.Trial RegistrationClinical Trial Registry of India Identifier: CTRI/2018/11/016448

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