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. 2022 May 6;22(1):161.
doi: 10.1186/s12903-022-02168-4.

Oral lichen planus: comparative efficacy and treatment costs-a systematic review

Shaiba Sandhu  1   2   3 , Brittany A Klein  4   5 , Malak Al-Hadlaq  4   5 , Prazwala Chirravur  4   5 , Amal Bajonaid  4   5 , Yuanming Xu  4   5 , Rossella Intini  4   5 , Mai Hussein  6   7 , Piamkamon Vacharotayangul  4   5 , Herve Sroussi  4   5 , Nathaniel Treister  4   5 , Stephen Sonis  4   5
Affiliations

Oral lichen planus: comparative efficacy and treatment costs-a systematic review

Shaiba Sandhu et al. BMC Oral Health. .

Abstract

Objective: To compare the reported efficacy and costs of available interventions used for the management of oral lichen planus (OLP).

Materials and methods: A systematic literature search was performed from database inception until March 2021 in MEDLINE via PubMed and the Cochrane library following PRISMA guidelines. Only randomized controlled trials (RCT) comparing an active intervention with placebo or different active interventions for OLP management were considered.

Results: Seventy (70) RCTs were included. The majority of evidence suggested efficacy of topical steroids (dexamethasone, clobetasol, fluocinonide, triamcinolone), topical calcineurin inhibitors (tacrolimus, pimecrolimus, cyclosporine), topical retinoids, intra-lesional triamcinolone, aloe-vera gel, photodynamic therapy, and low-level laser therapies for OLP management. Based on the estimated cost per month and evidence for efficacy and side-effects, topical steroids (fluocinonide > dexamethasone > clobetasol > triamcinolone) appear to be more cost-effective than topical calcineurin inhibitors (tacrolimus > pimecrolimus > cyclosporine) followed by intra-lesional triamcinolone.

Conclusion: Of common treatment regimens for OLP, topical steroids appear to be the most economical and efficacious option followed by topical calcineurin inhibitors. Large-scale multi-modality, prospective trials in which head-to-head comparisons interventions are compared are required to definitely assess the cost-effectiveness of OLP treatments.

Keywords: Cost; Critical review; Efficacy; Oral lichen planus; Treatment.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart for selection of studies in this systematic review
Fig. 2
Fig. 2
Treatment recommendations for treatment of OLP based on expert opinion
See this image and copyright information in PMC

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