Alshemmari Khaled A, Alzafiri Saud, Alajmi Mohammad, Alshammari Abdulaziz, Hashem Sayed, Alzafiri Khaled, AlQusaimi Reem, Alajmi Saleh, Aladwani Mohammd, Rasheed Gheith O
General Dentistry, Ministry of Health, Kuwait City, KWT.
Medicine and Surgery, Farwaniya Hospital, Ministry of Health, Kuwait City, KWT.
Cureus. 2024 Sep 23;16(9):e69973. doi: 10.7759/cureus.69973. eCollection 2024 Sep.
Oral lichen planus (OLP) is a potentially malignant disorder affecting the oral mucosa. Platelet concentrates, including platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have emerged as promising alternative treatments to corticosteroids. This study aims to comprehensively evaluate the effectiveness of PRP and PRF in the management of patients with OLP. We conducted a comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) involving patients with OLP comparing intralesional PRP or PRF with corticosteroids up to August 2024. The primary outcomes assessed were changes in lesion size, pain scores, and Thongprasom scores. Network meta-analysis (NMA) was used. Data were pooled using summary effect sizes with corresponding 95% confidence intervals (CIs) in a random-effects model based on the DerSimonian-Laird method. Eight studies comprising 157 patients and 250 lesions were included in the final analysis. Compared to corticosteroids, no significant differences were observed among PRF and PRP in terms of changes in lesion size, pain scores, clinical severity scores, and adverse events. NMA ranking showed that PRF was the best-ranking treatment in reducing lesion sizes (SUCRA values: 72.6%, 75.8%, 66.2%, 80.8%, and 77.5% at first, second, third, fourth, and eighth weeks of assessment), followed by corticosteroids, and PRP. Moreover, PRF was the best-ranking treatment in reducing pain score at the first, third, and eighth weeks of assessment (SUCRA values: 91.8%, 86%, and 85.9%), while PRP was the best intervention at the second and fourth weeks of assessment (SUCRA values: 61.3%, and 90.2%). Also, PRF was the best intervention in terms of Thongprasom scores at eight weeks of assessment (SUCRA value: 77.3%), while PRP was the best intervention at the fourth week of assessment with value of 78.1%. PRF and PRP showed comparable results with intralesional corticosteroids in all studied parameters. Considering treatments ranking, PRF was the best intervention. The optimal treatment modality for OLP varies on different clinical conditions.
口腔扁平苔藓（OLP）是一种影响口腔黏膜的潜在恶性疾病。血小板浓缩物，包括富血小板血浆（PRP）和富血小板纤维蛋白（PRF），已成为皮质类固醇有前景的替代治疗方法。本研究旨在全面评估PRP和PRF治疗OLP患者的有效性。我们对PubMed、Scopus、Web of Science和Cochrane图书馆进行了全面检索，以查找截至2024年8月涉及OLP患者的随机对照试验（RCT），比较病灶内注射PRP或PRF与皮质类固醇。评估的主要结局是病变大小、疼痛评分和通普拉松评分的变化。使用了网络荟萃分析（NMA）。数据采用基于DerSimonian-Laird方法的随机效应模型，使用汇总效应量及相应的95%置信区间（CI）进行合并。最终分析纳入了八项研究，共157例患者和250个病灶。与皮质类固醇相比，PRF和PRP在病变大小、疼痛评分、临床严重程度评分和不良事件的变化方面未观察到显著差异。NMA排名显示，PRF在减少病变大小方面是排名最佳的治疗方法（评估的第一、第二、第三、第四和第八周的累积排序曲线下面积值：72.6%、75.8%、66.2%、80.8%和77.5%），其次是皮质类固醇和PRP。此外，PRF在评估的第一、第三和第八周是减少疼痛评分方面排名最佳的治疗方法（累积排序曲线下面积值：91.8%、86%和85.9%），而PRP在评估的第二和第四周是最佳干预措施（累积排序曲线下面积值：61.3%和90.2%）。同样，PRF在评估八周时的通普拉松评分方面是最佳干预措施（累积排序曲线下面积值：77.3%），而PRP在评估第四周时是最佳干预措施，值为78.1%。在所有研究参数中，PRF和PRP与病灶内注射皮质类固醇的结果相当。考虑到治疗排名，PRF是最佳干预措施。OLP的最佳治疗方式因不同临床情况而异。
