Comparative Efficacy and Safety of Interventions for the Treatment of Oral Lichen Planus: A Systematic Review and Network Meta-Analysis

Abstract

Background: This systematic review and network meta-analysis aimed to assess comparative efficacy and safety of interventions to treat symptomatic, biopsy-proven oral lichen planus (OLP). Methods: Search was conducted for trials published in Medline, Embase and Cochrane Central Register of Controlled Trials. Network meta-analysis was performed on data from randomized controlled trials that assessed efficacy and safety of interventions used in the treatment of OLP. Agents were ranked according to their effectiveness in treatment of OLP based on outcomes using surface under the cumulative ranking [SUCRA]. Results: In total, 37 articles were included in the quantitative analysis. Purslane was clinically significant and ranked first in improving clinical symptoms [RR = 4.53; 95% CI: 1.45, 14.11], followed by aloe vera [RR = 1.53; 95% CI: 1.05, 2.24], topical calcineurin [RR = 1.38; 95% CI: 1.06, 1.81] and topical corticosteroid [RR = 1.35 95% CI: 1.05, 1.73]. Topical calcineurin demonstrated the highest incidence of adverse effects [RR, 3.25 [95% CI: 1.19, 8.86. Topical corticosteroids were significant in achieving clinical improvement of OLP with RR1.37 [95% CI: 1.03, 1.81]. PDT [MD = −5.91 [95% CI: −8.15, –3.68] and showed statistically significant improvement in the clinical score for OLP. Conclusions: Purslane, aloe vera and photodynamic therapy appear promising in treatment of OLP. More high-quality trials are recommended for strengthening the evidence. Although topical calcineurin is significantly efficacious in the treatment of OLP, significant adverse effects are a concern for clinical use. Based on the current evidence, topical corticosteroids are recommended for treatment of OLP owing to their predictable safety and efficacy.

Hyaluronic Acid as a Mechanism to Mitigate the Effects of Face Lower Third Aging in Dentistry: A Review

“…Other studies also broadly support the above findings, highlighting that the pharmacodynamics of HA in non-surgical aesthetic procedures, coupled with proper administration techniques, offer significant benefits in skin rejuvenation. This understanding reinforces the importance of HA as a viable option in dentistry and highlights the need for specialization of healthcare professionals (dentists) to ensure satisfactory aesthetic outcomes for patients [45][46][47]. Additionally, for a complete and integrated approach to facial aesthetic rehabilitation, it becomes necessary to start from the assessment of several facial parameters, namely: (i) face shape, appearance, and position of soft tissues (such as the nose, lips, and chin) and supporting structures (bones, cartilage, and teeth); (ii) muscle activity; and (iii) aging, i.e., the way these tissues have or will age [33,48,49].…”

Efficacy and safety of topical clobetasol propionate in comparison with alternative treatments in oral lichen planus: an updated systematic review and meta-analysis

“…In this updated search, we included eight more trials, building upon the previous network meta-analysis (NMA) (48). Unlike the previous NMA that found no clear clinical advantage of CLO over other treatments, our current meta-analysis distinctively underscores CLO's superiority.…”

“…It emerges as more effective in clinical resolution than therapies such as CYC, FLU, TRI, and AIM. This disparity can be attributed to the inclusion of newer trials and data with varied follow-up durations (48). Firstly, our study encompassed a larger number of relevant trials.…”