Acitretin plus triamcinolone treats oral lichen planus better than triamcinolone monotherapy

The combination of oral acitretin plus topical triamcinolone acetonide (TAC) appears to have superior efficacy than TAC alone in the treatment of patients with oral lichen planus, as shown in a study.

The study included 64 adult patients with symptomatic oral lichen planus. These patients were randomly assigned to receive a combination of oral acitretin (25-35 mg/d) plus TAC (treatment group; n=31, mean age 50.6 years, 61.3 percent women) or a combination of placebo plus TAC (placebo group; n=30, mean age 49.2 years, 50.0 percent women) for 28 weeks. All patients underwent an additional 8 weeks of treatment-free follow-up after the end of treatment (36 weeks of total study duration).

Outcomes assessed included disease severity and treatment response, which were assessed using Oral Disease Severity Score (ODSS), Oral Health Impact Profile 14 (OHIP-14), and visual analogue scale (VAS). The primary objective was to evaluate the proportion of patients achieving ODSS-75 (a 75-percent reduction in ODSS) in both groups at 28 weeks and at the end of 36 weeks.

At baseline, the two groups had comparable ODSS, VAS, and Oral Health Impact Profile 14 scores. Intention-to-treat analysis showed a significantly higher number of patients achieving ODSS-75 in the treatment group than in the placebo group at the end of week 28 (88 percent vs 47 percent; difference, 41 percentage point, 95 percent confidence interval [CI], 20–61; p<0.001) and week 36 (84 percent vs 41 percent; difference, 43 percentage point, 95 percent CI, 23–67; p<0.001).

Over the post-treatment follow-up, the rate of relapses was low among patients in both treatment and placebo groups (3 percent vs 6 percent).