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Interventions for treating oral lichen planus

Overview of attention for article published in Cochrane database of systematic reviews, January 2000
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Title
Interventions for treating oral lichen planus
Published in
Cochrane database of systematic reviews, January 2000
DOI 10.1002/14651858.cd001168
Pubmed ID
Authors

Chan, E S, Thornhill, M, Zakrzewska, J

Abstract

Oral lichen planus is a chronic autoimmune disease of unknown aetiology that affects the inner surface of the mouth. The symptomatic forms are painful,tend to worsen with age and with remissions being rare. Current treatment is palliative and not curative, many topical and systemic agents have been tried with little hard evidence for efficacy. To assess the effectiveness and safety of any form of palliative therapy against placebo for the treatment of symptomatic oral lichen planus. Electronic databases, handsearching of conference proceedings and specific journals, researchers in the field, drug manufacturers. Any placebo-controlled trial of palliative therapy for symptomatic oral lichen planus, using a randomised or quasi-randomised design that measured changes in symptoms and/or clinical signs. Change in symptoms (pain, discomfort) and clinical signs (visual impression, lesion measurements) at the end of therapy. Odds ratio of improvement vs no improvement for each trial outcome and pooling where appropriate. A total of nine RCTs were identified. The nine interventions were grouped into four separate classes (cyclosporines, retinoids, steroids and phototherapy) for comparison. No therapy was replicated exactly, the closest replication involved two trials using high and low dose cyclosporine mouthwash. Only trials recording the same outcomes in each therapeutic class were pooled. The largest number of pooled trials was three. Large odds ratios with very wide confidence intervals indicating a statistically significant treatment benefit were seen in all trials. However this has to be tempered by considerations of the small study sizes, the lack of replication, the difficulty in measuring outcome changes and the very high likelihood of publication bias. Only systemic agents were associated with treatment toxicities, all other side-effects were mild and mainly limited to local mucosal reactions. The review provides only weak evidence for the superiority of the assessed interventions over placebo for palliation of symptomatic OLP. The results highlight the need for larger placebo-controlled RCTs with more carefully selected and standardised outcome measures before between-treatment comparisons can be properly interpreted.

Mendeley readers

The data shown below were compiled from readership statistics for 96 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Germany 2 2%
United States 1 1%
Singapore 1 1%
Unknown 92 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 23 24%
Unspecified 13 14%
Researcher 13 14%
Student > Ph. D. Student 13 14%
Student > Bachelor 11 11%
Other 23 24%
Readers by discipline Count As %
Medicine and Dentistry 58 60%
Unspecified 20 21%
Agricultural and Biological Sciences 4 4%
Nursing and Health Professions 4 4%
Social Sciences 4 4%
Other 6 6%