Efficacy and safety of Tripterygium wilfordii Hook. f. for oral lichen planus: Evidence from 18 randomized controlled trials.
Adult
Drug-Related Side Effects and Adverse Reactions
/ epidemiology
Female
Glycosides
/ isolation & purification
Humans
Lichen Planus, Oral
/ drug therapy
Male
Middle Aged
Phytotherapy
Plant Extracts
/ therapeutic use
Plant Roots
/ chemistry
Randomized Controlled Trials as Topic
/ methods
Recurrence
Treatment Outcome
Tripterygium
/ chemistry
Tripterygium wilfordii Hook. f.
combination therapy
glycosides
meta-analysis
oral lichen planus
topical glucocorticoids
Journal
Phytotherapy research : PTR
ISSN: 1099-1573
Titre abrégé: Phytother Res
Pays: England
ID NLM: 8904486
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
10
11
2019
revised:
06
02
2020
accepted:
01
03
2020
pubmed:
18
3
2020
medline:
24
10
2020
entrez:
18
3
2020
Statut:
ppublish
Résumé
Glycosides from the roots of Tripterygium wilfordii Hook. f. are used for the treatment of oral lichen planus (OLP), a chronic inflammatory disease affecting the oral mucosa. To investigate the effectiveness and safety of Tripterygium glycosides (TGs) for OLP treatment, we conducted a systematic review of 18 randomized controlled trials, comprising 1,339 participants, from international and Chinese databases. We evaluated outcomes of TGs alone or in combination with conventional treatments. In combination with topical glucocorticoids (TGCs), including triamcinolone acetonide and prednisone, the total effectiveness rate (risk ratio [RR], 1.17; 95% confidence interval [CI], 1.09-1.25; p < .00001), symptom score reducing index (mean difference [MD], -2.44; 95% CI, -3.12 to -1.77; p < .0001), and visual analog scale score (MD, -1.61; 95% CI, -2.22 to -1.00; p < .0001) were significantly improved. Patients treated with TGs combined with TGCs experienced lower recurrence rates (RR, 0.37; 95% CI, 0.18-0.76; p = 0.007). The occurrence of adverse events was not significantly different between the TGs groups and controls. The combination of TG and TGCs improved clinical efficacy and reduced recurrence without increasing the risk of adverse events. A high-quality multicenter clinical study is needed to corroborate these findings.
Substances chimiques
Glycosides
0
Plant Extracts
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2180-2191Subventions
Organisme : National Key Research and Development Program of China
ID : 2018YFC1705301
Organisme : NSFC of China
ID : 81973860
Organisme : NSFC of China
ID : 81904214
Organisme : NSFC of China
ID : 81874470
Organisme : Shanghai Development Office of TCM
ID : ZY(2018-2020)-FWTX-1008
Organisme : Shanghai Development Office of TCM
ID : ZY(2018-2020)-CCCX-2004-08
Organisme : Shanghai Development Office of TCM
ID : ZY(2018-2020)-FWTX-4010
Informations de copyright
© 2020 John Wiley & Sons, Ltd.
Références
Aghbari, S. M. H., Abushouk, A. I., Attia, A., Elmaraezy, A., Menshawy, A., Ahmed, M. S., … Ahmed, E. M. (2017). Malignant transformation of oral lichen planus and oral lichenoid lesions: A meta-analysis of 20095 patient data. Oral Oncology, 68, 92-102. https://doi.org/10.1016/j.oraloncology.2017.03.012
Arduino, P., Campolongo, M., Sciannameo, V., Conrotto, D., Gambino, A., Cabras, M., … Carbone, M. (2018). Randomized, placebo-controlled, double-blind trial of clobetasol propionate 0.05% in the treatment of oral lichen planus. Oral Diseases, 24(5), 772-777. https://doi.org/10.1111/odi.12821
Arisawa, E. A., Almeida, J. D., Carvalho, Y. R., & Cabral, L. A. (2008). Clinicopathological analysis of oral mucous autoimmune disease: A 27-year study. Medicina Oral, Patologia Oral y Cirugia Bucal, 13, E94-E97. https://doi.org/10.1016/S0022-3913(08)60034-7
Cai, A., Qi, S., Su, Z., Shen, H., Ma, W., & Dai, Y. (2015). Tripterygium glycosides inhibit inflammatory mediators in the rat synovial RSC-364 cell line stimulated with interleukin-1. Biomedical Reports, 3(06), 763-766. https://doi.org/10.3892/br.2015.501
Carbone, M., Goss, E., Carrozzo, M., Castellano, S., & Gandolfo, S. (2003). Systemic and topical corticosteroid treatment of oral lichen planus: A comparative study with long-term follow-up. Journal of Oral Pathology and Medicine, 32(6), 323-329. https://doi.org/10.1034/j.1600-0714.2003.00173.x
Carrozzo, M., & Gandolfo, S. (2010). The management of oral lichen planus. Oral Diseases, 25(3), 176-182. https://doi.org/10.1046/j.1365-2230.2000.00607.x
Chamani, G., Rad, M., Zarei, M. R., Lotfi, S., Sadeghi, M., & Ahmadi, Z. (2015). Efficacy of tacrolimus and clobetasol in the treatment of oral lichen planus: A systematic review and meta-analysis. International Journal of Dermatology, 54(9), 996-1004. https://doi.org/10.1111/ijd.12925
Chen, B. J. (2001). Triptolide, a novel immunosuppressive and anti-inflammatory agent purified from a Chinese herb Tripterygium wilfordii Hook. f. Leukemia & Lymphoma, 42(03), 253-265. https://doi.org/10.3109/10428190109064582
Chen, H. J. (2012). Analysis on the curative effect of TCM dialectics in the treatment of oral lichen planus. Chinese and Foreign Medical Research, 10(31), 32-33.
Corrocher, G., Lorenzo, G. D., Martinelli, N., Mansueto, P., & Pacor, M. L. (2008). Comparative effect of tacrolimus 0.1% ointment and clobetasol 0.05% ointment in patients with oral lichen planus. Journal of Clinical Periodontology, 35(3), 244-249. https://doi.org/10.1111/j.1600-051X.2007.01191.x
Cribier, B., Frances, C., & Chosidow, O. (1998). Treatment of lichen planus. An evidence-based medicine analysis of efficacy. Archives of Dermatology, 134(12), 1521-1530. https://doi.org/10.1001/archderm.134.12.1521
Ding, J. (2018). Short-term efficacy of Tripterygium glycosides combined with triamcinolone acetonide in the treatment of erosive oral lichen planus. Chinese Basic Medicine, 25(12), 1549.
Eisen, D., Carrozzo, M., Bagan Sebastian, J. V., & Thongprasom, K. (2005). Number V. Oral lichen planus: Clinical features and management. Oral Diseases, 11(6), 338-349. https://doi.org/10.1111/j.1601-0825.2005.01142.x
Gangeshetty, N., & Kumar, B. P. (2015). Oral lichenplanus: Etiology, pathogenesis, diagnosis, and management. World Journal of Stomatology, 4(1), 12-21. https://doi.org/10.5321/wjs.v4.i1.12
Han, R., Rostami-Yazdi, M., Gerdes, S., & Mrowietz, U. (2012). Triptolide in the treatment of psoriasis and other immunemediated inflammatory diseases. British Journal of Clinical Pharmacology, 74(03), 424-436. https://doi.org/10.1111/j.1365-2125.2012.04221.x
Han, X. H., Nan, X. L., & Wu, Y. T. (2007). Clinical observation of total glycosides of paeony combined with Tripterygium glycosides in the treatment of oral lichen planus. China Medical Herald, 11, 74.
Higgins, J. P. T., & Green, S. (2018). Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0 [updated March 2011]. Cochrane Collaboration website. Retrieved from http://training.cochrane.org/handbook.
Jiang, H. J. (2016). Clinical efficacy of tacrolimus combined with Tripterygium glycosides in the treatment of oral lichen planus. General Journal of Stomatology, 3(23), 19-20.
Lehman, J. S., Tollefson, M. M., & Gibson, L. E. (2009). Lichen planus. International Journal of Dermatology, 48(7), 682-694. https://doi.org/10.1111/j.1365-4632.2009.04062.x
Li, J., Sha, Y., Zhang, X., Li, T. N., & Zhu, Q. J. (2018). Clinical observation on 32 cases of lichen planus treated with Tripterygium glycosides. Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine, 17(04), 358-359.
Liao, J. H., Zhao, R. H., Liu, H. Q., & Ma, F. C. (2009). Observation on short-term curative effect of Yindongzhen recipe on oral lichen planus. The Journal of Practical Medicine, 25(13), 2181-2182.
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P., … David, M. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ, 21(339), b2700. https://doi.org/10.2427/5768
Lin, L. M., & Qi, X. M. (2005). Comparative observation on the effects of Radix Tripterygium hypoglaucum tablet and Tripterygium glycosides tablet in treating erosive oral lichen planus. Chinese Journal of Integrative Medicine, 11(2), 149-150. https://doi.org/10.1007/bf02836474
Liu, C., Xie, B., Yang, Y., Lin, D. X., Wang, C., Lin, M., & Zhou, H. M. (2013). Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: A randomized, controlled trial. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 116, 584-590. https://doi.org/10.1016/j.oooo.2013.07.023
Liu, G. C., Yang, Y. P., & Zhao, Y. Z. (2017). Clinical analysis of triamcinolone acetonide combined with Tripterygium glycosides in the treatment of oral lichen planus. China Practical Medicine, 12(03), 6-8.
Liu, L., Luo, Y., Zhou, M., Lu, Y., Xing, M., Ru, Y., … Li, X. (2019). Tripterygium agents for the treatment of atopic eczema: A Bayesian analysis of randomized controlled trials. Phytomedicine, 59, 152914. https://doi.org/10.1016/j.phymed.2019.152914
Liu, L., Zhao, H. B., Sun, X. Y., Zheng, Q., Luo, Y., Ru, Y., … Li, X. (2018). Efficacy and safety of Tripterygium wilfordii Hook. f. for chronic urticaria: A systematic review and meta-analysis. BMC Complementary and Alternative Medicine, 18, 243. https://doi.org/10.1186/s12906-018-2305-7
Liu, X. Q., & Xu, X. M. (2018). Observation on the curative effect of Kangfuxin liquid combined with Tripterygium glycosides in the treatment of OLP. Gansu Medical Journal, 37(05), 444-445.
Meng, L., Jingwen, D., Nan, T., Zeng, Y. J., & Lu, C. J. (2018). Efficacy and safety of Tripterygium wilfordii Hook. f. on psoriasis vulgaris: A systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine, 2018, 1-10. https://doi.org/10.1155/2018/2623085
Mortazavi, H., Baharvand, M., & Mehdipour, M. (2014). Oral potentially malignant disorders: An overview of more than 20 entities. Journal of Dental Research, Dental Clinics, Dental Prospects, 8(1), 6-14. https://doi.org/10.5681/joddd.2014.002
Muzio, L. L., Della Valle, A., Mignogna, M. D., Pannone, G., Bucci, P., Bucci, E., & Sciubba, J. (2001). The treatment of oral aphthous ulceration or erosive lichen planus with topical clobetasol propionate in three preparations: A clinical and pilot study on 54 patients. Journal of Oral Pathology & Medicine, 30(10), 611-617. https://doi.org/10.1034/j.1600-0714.2001.301006.x
Nogueira, P. A., Carneiro, S., & Ramos-E-Silva, M. (2015). Oral lichen planus: An update on its pathogenesis. International Journal of Dermatology, 54(9), 1005-1010. https://doi.org/10.1111/ijd.12918
Professional Committee on Oral Mucosal Diseases of Chinese Stomatological Association. (2005). Evaluation criteria for curative effect of oral lichen planus (atrophic, erosive type). Chinese Journal of Stomatology, 40, 92-93.
Qi, A. R., Fu, B., Liu, X. Y., Li, S. M., Wen, S. S., Zheng, P., & Chen, J. P. (2018). Study on the Content of Six Components in Different Tripterygium Wilfordii Preparations.Medical Information, 31(05):70-73.
Radfar, L., Wild, R. C., & Suresh, L. (2008). A comparative treatment study of topical tacrolimus and clobetasol in oral lichen planus. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontology, 105(2), 0-193. https://doi.org/10.1016/j.tripleo.2007.07.029
Ren, C. Q., & Zhou, J. H. (2016). Clinical study of tacrolimus combined with Tripterygium glycosides in the treatment of oral lichen planus. Journal of Clinical Stomatology, 32(09), 545-547.
Ren, C. Q., Zhou, J. H., & Qin, D. Q. (2012). Evaluation of the efficacy of triamcinolone acetonide combined with Tripterygium glycosides in the treatment of OLP. Journal of Clinical Stomatology, 28(12), 734-735.
Ru, Y., Luo, Y., Zhou, Y., Kuai, L., Sun, X., Xing, M., … Li, X. (2019). Adverse events associated with treatment of Tripterygium wilfordii Hook. f.: A quantitative evidence synthesis. Frontiers in Pharmacology, 10, 1250. https://doi.org/10.3389/fphar.2019.01250
Scully, C., & Carrozzo, M. (2008). Oral mucosal disease: Lichen planus. British Journal of Oral & Maxillofacial Surgery, 46(1), 0-21. https://doi.org/10.1016/j.bjoms.2007.07.199
Shi, W. Y., Wang, X. D., & Qu, C. J. (2014). Clinical observation of thalidomide in the treatment of 35 cases of erosive oral lichen planus. China Medical Abstract of Dermatology, 31(06), 341-342.
Si, H. Y., Zhang, Y. X., Han, L. H., & Feng, S. X. (2011). Clinical observation on treatment of recurrent lichen planus with combination of traditional Chinese medicine and western medicine. Chinese Medicine Modern Distance Education of China, 9(22), 42-43.
Sobaniec, S., Bernaczyk, P., Pietruski, J., Cholewa, M., Skurska, A., Dolińska, E., & Pietruska, M. (2013). Clinical assessment of the efficacy of photodynamic therapy in the treatment of oral lichen planus. Lasers in Medical Science, 28(1), 311-316. https://doi.org/10.1007/s10103-012-1153-9
Suresh, S. S., Chokshi, K., Desai, S., Malu, R., & Chokshi, A. (2016). Medical management of oral lichen planus: A systematic review. Journal of Clinical & Diagnostic Research Jcdr, 2016(10), ZE10. https://doi.org/10.7860/JCDR/2016/16715.7225
Tao, X., & Lipsky, P. E. (2000). The Chinese anti-inflammatory and immunosuppressive herbal remedy Tripterygium wilfordii Hook. f. Rheumatic Disease Clinics of North America, 26(01), 29-50. https://doi.org/10.1016/S0889-857X(05)70118-6
Wang, Y. D., Wang, Q., Zhang, J. B., Dai, Z., Lin, N., Wu, X. F., & Ma, S. C. (2019). Research progress on chemical constituents and quality control of Tripterygium wilfordii preparations. China Journal of Chinese Materia Medica, 16, 3368-3373. https://doi.org/10.19540/j.cnki.cjcmm.20190606.501
Yin, C., Liang, M., & Wang, X. (1996). Clinical analysis of 110 cases of oral lichen planus treated with triamcinolone acetonide and/or Tripterygium glycosides. Journal of Dental Prevention and Treatment, 4(01), 18-19.
Zhang, H., & Chen, W. (2017). Interleukin 6 inhibition by triptolide prevents inflammation in a mouse model of ulcerative colitis. Experimental and Therapeutic Medicine, 14, 2271-2276. https://doi.org/10.3892/etm.2017.4778
Zhang, Q. (2016). Study on platelet aggregation rate, hemorheology and clinical efficacy of Acanthopanax senticosus Huangqi tablets and Tripterygium glycosides before and after treatment of oral lichen planus. China Practical Medicine, 11(15), 180-181.
Zhao, C. Y. (2015). Clinical observation of triamcinolone acetonide combined with Tripterygium glycosides in the treatment of oral lichen planus. Gansu Medical Journal, 34(01), 65-66.
Zhong, J. B., Feng, X., & Shan, Y. (2013). Clinical study on treatment of oral lichen planus with combination of traditional Chinese medicine and Western medicine. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine, 13(09), 49-59.
Zhu, W. B., & Li, Z. (2019). Clinical efficacy of triamcinolone acetonide combined with Tripterygium glycosides in the treatment of oral lichen planus. General Journal of Stomatology, 6(01), 6-7.