Calcineurin inhibitors in oral medicine

Johani, Khalid; Hegarty, Anne M; Porter, Stephen; Fedele, Stefano

doi:10.1016/j.jaad.2009.03.012

Cited by 45 publications

(45 citation statements)

References 94 publications

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“…In a RCT [57], though clinically it has been observed a better improvement in patients undergone to steroid respect to cyclosporine group, the enhancement of pain is similar when patients applied steroids or cyclosporine. In a case series study [13,58] it has been evaluated cyclosporine in patients with desquamative gingivitis: six patients used cyclosporine solution (100 mg/ml) to rinse one time for 5 minutes every day. In five patients it has been observed a complete resolution of gingival soreness within 2-4 weeks, while there were persistent lesions on dorsum of the tongue and gingival; hence, no patient had total healing of involved areas.…”

Section: Calcineurin Inhibitors (Cyclosporina Pimecrolimus Tacrolimus)mentioning

confidence: 99%

“…Topical tacrolimus, in two concentrations 0,03% and 0,1%, is competent to obtain relief of pain, even if the first one does not warrant a complete healing, whereas its cessation determines recurrences within 1 or 2 weeks [13]. Since minimal side effects are reported [15] (<25% of treated individuals), the use of tacrolimus could be suggested as a first line treatment in steroid-recalcitrant lesions, in susceptible patients for candidiasis and for other immunosuppressive-adverse effects.…”

Section: Calcineurin Inhibitors (Cyclosporina Pimecrolimus Tacrolimus)mentioning

confidence: 99%

“…In an open clinical trial [13] it has been appraised the clinical efficacy and safety profile of tacrolimus powder in orabase 0.1% in 7 patients with OLP and 3 lichenoid lesions.…”

Section: Calcineurin Inhibitors (Cyclosporina Pimecrolimus Tacrolimus)mentioning

confidence: 99%

“…Oral lichen planus (OLP) affects 2% of the population with the highest incidence in women (2: 1), and the most affected age ranges from 40-70 years [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Topical Therapies for Oral Lichen Planus Management and their Efficacy: A Narrative Review

Bagán

Compilato²,

Paderni³

et al. 2012

CPD

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Oral Lichen Planus (OLP) is a chronic inflammatory condition implicating T cell-mediated cytotoxicity, and involving oral mucosal surfaces. Several therapeutic regimens have been evaluated to treat OLP and pain related, but often without high level of evidence. Topical formulations are the favourite for the majority of cases; bioadhesive formulations have been considered very useful and practical for local drug delivery in oral mucosa, due to the increased residence time on the oral mucosa of the dosage forms and better therapeutic efficacy.In this narrative review, authors try to illustrate the current topical managements for OLP from the accessible literature on this topic. Steroids are very helpful in discomfort and making better quality of life: they are considered the first-line treatment even if they could cause secondary candidosis, and sometimes bad taste, nausea, dry mouth, sore throat or swollen mouth.Other substances or devices by topical administration are adopted especially when the first line approach is refractory. This is the case when retinol with its synthetic and natural analogues (retinoids), hyaluronic acid, or Aloe Vera are chosen.Recent topical applications for OLP therapy include phototherapy and low/high energy pulsing light; the treatment with extracorporeal photochemotherapy is also reasonable and promising.Finally, calcineurin inhibitors (i.e. cyclosporine, tacrolimus and pimecrolimus), antioxidant and biologics (i.e alefacept, efalizumab, basiliximab, TNF-inhibitors -infliximab, rituximab) may be alternative approaches when OLP does not respond to the standard protocols.In this scenario, there are several studies on molecules different from glucocorticosteroids, but not sufficient or statistically adequate to justify their evidence-based use in OLP; large randomized placebo controlled trials are required to evaluate the safety and effectiveness of these non conventional therapies.In conclusion, since OLP is a chronic disease and requires long-term management, the dental/medical practitioner, who treats OLP patients, needs to know the natural history of OLP, how to monitor, and how to treat, taking in account all of the available modalities conventional and not, with pros and cons.

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Section: Calcineurin Inhibitors (Cyclosporina Pimecrolimus Tacrolimus)mentioning

confidence: 99%

Section: Calcineurin Inhibitors (Cyclosporina Pimecrolimus Tacrolimus)mentioning

confidence: 99%

“…In an open clinical trial [13] it has been appraised the clinical efficacy and safety profile of tacrolimus powder in orabase 0.1% in 7 patients with OLP and 3 lichenoid lesions.…”

Section: Calcineurin Inhibitors (Cyclosporina Pimecrolimus Tacrolimus)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Topical Therapies for Oral Lichen Planus Management and their Efficacy: A Narrative Review

Bagán

Compilato²,

Paderni³

et al. 2012

CPD

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“…It is a relatively selective inhibitor of calcineurin and it was initially developed as a systemic agent to lessen allograft rejection [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

Topical Tacrolimus and Periodontal Therapy in the Management of a Case of Oral Chronic GVHD Characterized by Specific Gingival Localization

Conrotto

Broccoletti

Carcieri

et al. 2014

Case Reports in Dentistry

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Background. Chronic graft versus host disease (cGVHD) is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.

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Drug-Induced Oral Infections

Boisramé

Chaux-Bodard

2021

Drug-Induced Oral Complications

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Calcineurin inhibitors in oral medicine

Cited by 45 publications

References 94 publications

Topical Therapies for Oral Lichen Planus Management and their Efficacy: A Narrative Review

Topical Therapies for Oral Lichen Planus Management and their Efficacy: A Narrative Review

Topical Tacrolimus and Periodontal Therapy in the Management of a Case of Oral Chronic GVHD Characterized by Specific Gingival Localization

Drug-Induced Oral Infections

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