Department of Oral Medicine and Radiology, D Y Patil University, School of Dentistry, Navi Mumbai, India.
Department of Public Health Dentistry, D Y Patil University, School of Dentistry, Navi Mumbai, India.
Asian Pac J Cancer Prev. 2023 Feb 1;24(2):389-400. doi: 10.31557/APJCP.2023.24.2.389.
Tacrolimus is a powerful macrolide calcineurin inhibitor that has low adverse effects which lead to a rapid response in the control of signs and symptoms in comparison to that of corticosteroids in Oral Lichen Planus(OLP). There have been increasing number of studies establishing the use of topical tacrolimus in oral lichen planus. Still, there is a need to find evidence of the successful use of tacrolimus in comparison to other drugs used in the treatment of OLP, by means of a systematic review and meta-analysis, so that an informed and accurate approach can be utilized.
A comprehensive literature review was performed, including PubMed, the Cochrane Library, published up to and including December 2021. There were no restrictions on date of publication. Articles available in English language were included. Using the Cochrane Collaboration tool, we assessed the risk of bias for randomized controlled trials. A meta-analysis was performed on the relevant studies.
A total of 11 RCTs evaluating the effects of tacrolimus were included in this study after application of inclusion and exclusion criteria. Seven studies revealed a low bias risk, three presented a moderate risk and one had a high risk of bias. The results revealed no significant difference in clinical resolution and adverse effects between tacrolimus and corticosteroids. The pooled data from our meta-analysis shows that there is not sufficient evidence to prove that Tacrolimus is better in efficacy than other topical corticosteroids.
According to the current systematic study and meta-analysis, there is not sufficient evidence to prove that Tacrolimus is better in efficacy than other drugs. Uniform trials are required with larger sample sizes and standardized methodology are required for a better analysis.
他克莫司是一种强效大环内酯类钙调磷酸酶抑制剂，与皮质类固醇相比，其不良反应较低，能迅速控制口腔扁平苔藓（OLP）的症状和体征。越来越多的研究表明，局部使用他克莫司治疗口腔扁平苔藓有效。然而，仍需要通过系统评价和荟萃分析来寻找他克莫司与其他治疗 OLP 药物相比成功应用的证据，以便采用一种明智而准确的方法。
进行了全面的文献检索，包括 PubMed、Cochrane 图书馆，检索截至 2021 年 12 月。对发表日期没有限制。纳入了英语发表的文章。我们使用 Cochrane 协作工具评估了随机对照试验的偏倚风险。对相关研究进行了荟萃分析。
应用纳入和排除标准后，本研究共纳入了 11 项评估他克莫司疗效的 RCT。其中 7 项研究显示偏倚风险低，3 项研究显示偏倚风险中度，1 项研究显示偏倚风险高。结果显示，他克莫司与皮质类固醇在临床缓解和不良反应方面无显著差异。我们的荟萃分析汇总数据表明，没有足够的证据证明他克莫司在疗效方面优于其他局部皮质类固醇。
根据目前的系统研究和荟萃分析，没有足够的证据证明他克莫司在疗效方面优于其他药物。需要进行具有更大样本量和标准化方法的统一试验，以便进行更好的分析。
