Oral Acitretin and TAC Effective in treatment of Oral Lichen Planus: JAMA

Symptomatic Oral Lichen Planus (OLP) has been a formidable challenge to treat, but a recent clinical trial revealed a positive outcome. The study from Postgraduate Institute of Medical Education and Research in Chandigarh, compared the efficacy of a combination therapy of oral acitretin with topical triamcinolone acetonide (TAC) and 0.1%—with TAC monotherapy in patients with symptomatic OLP. The findings of the study were published in Journal of American Medical Association.

This investigator-initiated trial involved 64 patients aged 18 and older with symptomatic OLP, employing a placebo-controlled, investigator- and patient-blinded randomized design. The patients were randomized into a group receiving a combination of oral acitretin and TAC, and the other group receiving TAC combined with a placebo. The treatment was for 28 weeks with an additional 8 weeks of treatment-free follow-up.

Results showed a statistically significant advantage for the combination therapy. In the intention-to-treat analysis, a higher number of patients in the treatment group achieved a 75% or higher reduction in Oral Disease Severity Score (ODSS) compared to the placebo group at both 28 weeks and 36 weeks.

The combination therapy demonstrated a superior performance in the reduction of relapses during the posttreatment follow-up. The low relapse rates further solidified the effectiveness of the dual approach, offering a ray of hope for patients suffering with symptomatic OLP.

This trial opened new doors for managing OLP, indicating that a combination of oral acitretin and TAC might be a potent therapeutic strategy than TAC monotherapy. The medical community anticipates the treatment landscape for symptomatic OLP by improving the quality of life for many individuals affected by this challenging condition.

Source:

Vinay, K., Kumar, S., Dev, A., Cazzaniga, S., Borradori, L., Thakur, V., & Dogra, S. (2023). Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus. In JAMA Dermatology. American Medical Association (AMA). https://doi.org/10.1001/jamadermatol.2023.4889