Efficacy of topical administration for oral lichen planus: A network meta-analysis.
calcineurin inhibitor
corticosteroid
network meta-analysis
oral lichen planus
topical administration
Journal
Oral diseases
ISSN: 1601-0825
Titre abrégé: Oral Dis
Pays: Denmark
ID NLM: 9508565
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
revised:
04
01
2021
received:
28
08
2020
accepted:
21
01
2021
pubmed:
3
2
2021
medline:
9
3
2022
entrez:
2
2
2021
Statut:
ppublish
Résumé
To examine the comparative efficacy and safety of topical administration for oral lichen planus. An electronic database search (1st January 1946 to 1st May 2020) for randomised controlled trials identified 34 studies involving eight interventions (clobetasol, betamethasone, triamcinolone, dexamethasone, fluocinolone, tacrolimus, pimecrolimus, and cyclosporine); these studies were subjected to network meta-analysis using direct and indirect comparisons [efficacy indicators: clinical response rate, symptom-reducing effect (visual analogue scale score), sign-reducing effect (Thongprasom-scale score) and relapse; safety indicator: adverse event occurrence]. Compared with placebo, tacrolimus had the best clinical response rate (odds ratio (OR), 57.78 [95% CI 3.15-1060.52]; P-score, 0.8654) and cyclosporine had the worst (OR, 3.61[95% CI 0.20-66.62]; P-score, 0.2236); tacrolimus had the best symptom-reducing effect (standardised mean difference (SMD), 1.06 [95% CI 0.41-1.71]; P-score, 0.9323) and fluocinolone had the worst (SMD, -0.54 [95% CI -1.44-0.36]; P-score, 0.0157); dexamethasone had the best sign-reducing effect (SMD, 3.60 [95% CI 1.74-5.45]; P-score, 0.8306) and clobetasol had the worst (SMD, 2.63 [95% CI 1.66-3.61]; P-score, 0.2581); and pimecrolimus performed best (OR, 0.04 [95% CI 0.00-0.64]; P-score, 0.9227) and clobetasol performed the worst [OR, 0.60; 95% CI 0.15-2.45; P-score, 0.2545] in reducing relapse. Regarding safety, dexamethasone was the safest compared with placebo [OR, 0.37; 95% CI 0.05-2.57; P-score, 0.9337), whereas fluocinolone ranked low for safety [OR, 9.48; 95% CI 1.50- 60.03; P-score, 0.1189]. The relative ranking of topical administration varies according to the different indicators. Based on the joint consideration of clinical response rate and adverse event occurrence, dexamethasone, triamcinolone and betamethasone are recommended for better efficacy and safety. The optimal treatment for oral lichen patients varies under different conditions.
Substances chimiques
Betamethasone
9842X06Q6M
Clobetasol
ADN79D536H
Tacrolimus
WM0HAQ4WNM
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Pagination
670-681Subventions
Organisme : National Natural Science Foundation of China
ID : 81730030
Organisme : National Natural Science Foundation of China
ID : 81872208
Organisme : Sichuan Province Science and Technology Planning Project
ID : 2020JDJQ0013
Organisme : Sichuan University Postdoctoral Research Foundation
ID : 19XJ0008
Informations de copyright
© 2021 Wiley Periodicals LLC.
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