Objective To systematically evaluate the efficacy and safety of tacrolimus and glucocorticoid for oral lichen planus (OLP). Methods The Cochrane review’s method was adopted and computer-based retrieval was performed on The Cochrane Library, MEDLINE, EMbase, CBM, and CNKI (from their establishment to November 2010) to collect randomized controlled trials (RCTs) comparing the clinical efficacy of tacrolimus in treating OLP with that of triamcinolone. The study was selected according to the inclusion and exclusion criteria, the data were collected, and the methodological quality of the included studies was evaluated. The RevMan 5.0.25 software was applied for statistical analyses. Results Four RCTs involving 164 patients were included. Two studies showed that the tacrolimus effectively reduced lesion area and alleviated pain of patients with OLP. The results of meta-analyses showed that the total effective rate of tacrolimus was not higher than that of glucocorticoid (OR=4.38, 95%CI 0.67 to 28.73), and there was no significant difference between the tacrolimus group and the glucocorticoid group in adverse events during the treatment session (OR=3.49, 95%CI 0.49 to 24.84), and there was no significant difference in recurrence rate between those two groups (OR=0.82, 95%CI 0.27 to 2.46). Conclusion Topical tacrolimus can remarkably improve the OLP sign (lesion area) and symptom (pain), which is in line with the findings of other non-RCTs. The current evidence proves that the tacrolimus is similar to glucocorticoid in terms of the total effective rate of treating OLP, the incidence of side reaction during treatment, and the recurrence rate after stopping treatment. Some studies included in this systematic review apply different assessment methods, hence more RCTs with high-quality, multi-center, and therapeutic evaluation indexes with corresponding evaluation methods are required to provide more reliable evidence.
Objective To evaluate the efficacy and safety of pimecrolimus for oral lichen planus (OLP). Methods We searched The Cochrane Library, MEDLINE (1990 to 2007), EMBASE (1990 to 2007), and the Chinese Biomedicine Database (1990 to 2007) to collect parallel group randomized controlled trials (RCTs) and cross-over trials comparing pimecrolimus with triamcinolone acctonide or placebo. The Cochrane Collaboration’s RevMan 4.2 software was used for data analyses. Results Three RCTs were included. Meta-analyses showed that pimecrolimus did not improve oral cavity ache measured by VAS (visual analogue scale) (WMD –0.5, 95%CI –9.77 to 8.77), OHIP (oral health impact profile) (WMD 0.9, 95%CI –0.6 to 2.4) and CSS (clinical status score) (WMD 0.00mm2, 95%CI –0.40 to 0.40); compared with triamcinolone acctonide. In comparison to placebo, pimecrolimus did not improve oral cavity ache measured by VAS (WMD –3.30, 95%CI –20.20 to 13.92) or CSS (WMD –56.57, 95%CI -134.02 to 20.88) and did not reduce burning sensations (OR 4.98, 95%CI 0.49 to 50.22) as well. Conclusion Pimecrolimus should not be regarded as a better choice than triamcinolone acctonide or placebo for improving the VAS, OHIP or CSS of patients with oral lichen planus. Since the RCTs available for this systematic review are too small, further high-quality large-scale RCTs with standard clinical evaluation are required to provide more reliable evidence.
ObjectivesTo systematically review the efficacy and safety of hydroxychloroquine (HCQ) and chloroquine (CQ) for oral lichen planus (OLP).MethodsPubMed, The Cochrane Library, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of HCQ and CQ for OLP from inception to September, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 10 RCTs involving 726 patients were included. The results of meta-analysis showed that: HCQ or CQ were more effective than placebos (P<0.05). Nevertheless, they were inferior to oral traditional Chinese medicine (RR=0.75, 95%CI 0.69 to 0.82, P<0.000 01). In addition, the ratio of CD4+/CD8+ T cell increased significantly in peripheral blood of OLP patients after treatment with HCQ or CQ (MD=–0.28, 95%CI –0.44 to –0.13, P=0.000 3). The incidences of adverse reaction of HCQ or CQ were higher than orally traditional Chinese medicine (RR=11.80, 95%CI 4.85 to 28.68, P<0.000 01), and the difference was statistically significant.ConclusionsCurrent evidence shows that the efficacy of HCQ or CQ for OLP were significantly superior to placebo, while inferior to orally traditional Chinese medicine. The possible therapeutic mechanism of HCQ or CQ for OLP may be related to the regulation of the ratio of CD4+/CD8+ T cells and cellular immunity of OLP patients. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo analyze the hotspots and frontiers of oral lichen planus research by bibliometric methods.MethodsWe searched Web of Science Core Collection database to obtain studies on oral lichen planus from inception to January 1st, 2020. After data extraction, Excel 2016 and CiteSpace software were used to carry out descriptive and visual analysis.ResultsA total of 3 105 articles and reviews were included, and the annual publication volume showed a steady growth trend. The research hotspot terms of oral lichen planus were cancer, lesion, and management of the disease. Moreover, pathogenesis, potentially malignant disorder, classification, and diagnosis were defined as novel research frontiers.ConclusionsThrough the bibliometric method, the research hotspots and frontiers of oral lichen planus are displayed intuitively, which provides references for future research.