A Meta-analysis Of The Efficacy And Safety Of Topical Tacrolimus In The Treatment Of Erosive Oral Lichen Planus

Objective: In this systematic study,evidence-based medicine was used to comprehensively and systematically evaluate the clinical efficacy and safety of topical products(ointments or mouthwash)of tacrolimus in the treatment of erosive oral lichen planus and to observe its short-term and long-term efficacy,so as to provide evidence and guidance for its clinical application.Methods: A computer search combined with a manual search for a randomized controlled clinical trial of lichen planus for the treatment of erosive oral lichen planus,compared with corticosteroid,was performed using: China journal full-text database and Chinese biomedical literature database,a database of ten thousand,VIP,Pubmed,OVID,Web of Science,Embase,the Cochrane Library,published in the year to date in December 2019.Two researchers filtered according to the inclusion criteria and exclusion criteria,according to the Cochrane intervention measures system evaluation handbook version 5.1.0 to evaluate risk of bias in test.The relative risk and 95% confidence interval were used to calculate the combined efficiency,adverse events and recurrence rate.Weighted mean difference and 95% confidence interval were used to combine computational visual simulation score and clinical score.Heterogeneity of data was tested by statistical methods,namely Q test and I test.The publication bias test was conducted by Egger’s linear regression method.Stata14.2 software was used for the above statistical analysis.Results:1.A total of 27 randomized controlled clinical studies with a total of 27 articles met the inclusion and exclusion criteria.2.Results of meta-analysis on effective rate: effective rate RR=1.02,95%CI(1.22,1.210),P=0.022 after treatment,showing statistical difference.3.Results of meta-analysis of visual simulation scores after treatment: WMD=-0.48,95%CI(-1.03,0.08),P=0.091,no statistical significance.4.Results of meta-analysis of clinical scores after treatment: WMD=0.13,95%CI(-0.55,0.80),P=0.713,no statistical significance.5.Meta-analysis of safety and adverse events: RR=0.62,95%CI(0.44,0.88),P=0.007,with statistical significance.6.The results of meta-analysis on the recurrence rate of 1 month(2-5 weeks)follow-up: RR=0.67,95%CI(0.40,1.13),P=0.131,with no statistical significance.7.Recurrence rate for 6 months of follow-up: RR=0.70,95%CI(0.40,1.13),P=0.131,no statistical significance.Conclusions:1.The effective rate of topical products of tacrolimus for the treatment of erosive oral lichen planus was higher than that of traditional corticosteroids,but there was no significant difference in therapeutic effect between 0.03% and 0.1% concentrations.2.Tacrolimus topical products are safer,with a lower incidence of adverse events than corticosteroids,where a concentration of 0.03% is safer than a concentration of 0.1%.3.At 1 month and 6 months,there was no statistically significant difference in the efficacy of tacrolimus versus corticosteroid topical products in the treatment of erosive oral lichen planus.4.The clinical efficacy of tacrolimus topical products remains to be studied in more long-term and high-quality randomized controlled clinical trials.