Efficacy of topical administration for oral lichen planus: A network meta-analysis
Peiyang Yuan
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Formal analysis, Investigation, Software, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorXuemei Qiu
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Validation, Writing - review & editing
Search for more papers by this authorLu Ye
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorFeifei Hou
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorYuye Liang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Validation, Writing - review & editing
Search for more papers by this authorHan Jiang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorYuting Zhang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Visualization, Writing - review & editing
Search for more papers by this authorYiming Xu
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorYutong Sun
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorXiaoting Deng
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorCorresponding Author
Hao Xu
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Correspondence
Lu Jiang and Hao Xu, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
Emails: [email protected]; [email protected]
Contribution: Conceptualization, Funding acquisition, Methodology, Project administration, Resources, Software, Writing - review & editing
Search for more papers by this authorCorresponding Author
Lu Jiang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Correspondence
Lu Jiang and Hao Xu, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
Emails: [email protected]; [email protected]
Contribution: Conceptualization, Funding acquisition, Project administration, Resources, Software, Supervision, Writing - review & editing
Search for more papers by this authorPeiyang Yuan
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Formal analysis, Investigation, Software, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorXuemei Qiu
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Validation, Writing - review & editing
Search for more papers by this authorLu Ye
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorFeifei Hou
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorYuye Liang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Validation, Writing - review & editing
Search for more papers by this authorHan Jiang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorYuting Zhang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Data curation, Visualization, Writing - review & editing
Search for more papers by this authorYiming Xu
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorYutong Sun
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorXiaoting Deng
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorCorresponding Author
Hao Xu
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Correspondence
Lu Jiang and Hao Xu, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
Emails: [email protected]; [email protected]
Contribution: Conceptualization, Funding acquisition, Methodology, Project administration, Resources, Software, Writing - review & editing
Search for more papers by this authorCorresponding Author
Lu Jiang
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Correspondence
Lu Jiang and Hao Xu, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
Emails: [email protected]; [email protected]
Contribution: Conceptualization, Funding acquisition, Project administration, Resources, Software, Supervision, Writing - review & editing
Search for more papers by this authorAbstract
Objective
To examine the comparative efficacy and safety of topical administration for oral lichen planus.
Materials and Methods
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].
Results
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].
Conclusions
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.
CONFLICT OF INTEREST
The authors state they have no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
All data generated or analysed during this study was taken from published RCTs and systematic reviews. The data are included in this article (and its supporting file.)
Supporting Information
| Filename | Description |
|---|---|
| odi13790-sup-0001-Supinfo.docxWord 2007 document , 5.6 MB | Supplementary Material |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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