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Medicine Oral Medicine

Are there any interventions for treating oral lichen planus?

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This summary is based on the Cochrane Review: Interventions for treating oral lichen planus (July 2011)

 

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Context

Oral lichen planus (OLP) is a common chronic autoimmune disease associated with cell-mediated immunological dysfunction. Symptomatic OLP is painful and complete healing is rare. It is a condition where there are long-term, painful areas on the lining of the mouth. The treatment is for reducing pain but there is no cure for this disease. Usual treatment is steroid ointment applied directly to the painful areas. This review found no research evidence to show that one type of steroid is better or worse than another. There is no evidence that a group of treatments called calcineurin inhibitors (e.g. pimecrolimus) are more effective than placebo. This review found that aloe vera may reduce pain and clinical signs of OLP.

Purpose of the Study

Assess the effectiveness and safety of any form of therapy for symptomatic OLP.

Method

Article selection criteria: all randomised controlled clinical trials (RCTs) of therapy for symptomatic OLP which compared treatment with a placebo or between treatments or no intervention were considered in this review.

Key Messages

  • Although topical steroids are considered to be first line treatment, there were no RCTs identified that compared steroids with placebo in patients with symptomatic OLP.
  • From the trials in this review, there is no evidence that one steroid is any more effective than another.
  • There is weak evidence that aloe vera may reduce the pain of OLP and improve the clinical signs of disease compared to placebo.
  • There is weak and unreliable evidence that cyclosporin may reduce pain and clinical signs of OLP.
  • There is no evidence that other calcineurin inhibitors reduce pain compared to either steroids or placebo.
  • From the 28 trials included in this systematic review, the wide range of interventions compared means there is insufficient evidence to support the effectiveness of any specific treatment as being superior.

 

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