Efficacy of Topical Tacrolimus for Erosive Oral Lichen Plan us： A Meta-analysis

Objective To assess the efficacy and safety of topical tacrolimus for erosive oral lichen planus （EOLP）. Methods Literatures published up to December 2013 were searched from PubMed, Embase,CENTRAL, Chinese BioMedical Literature Database （CBM）, and System for Information on Grey Literaturein Europe （SIGLE）. All randomized controlled trials （RCTs） of topical tacrolimus for EOLP which comparedwith other interventions or a placebo were considered in this Meta-analysis. Two researchers collected dataindependently. The assessment of methodological quality was based on Cochrane Handbook and the materialswere analyzed with the software Revman 5.2.5. The primary outcome measures were the symptoms （e.g. pain,discomfort） complained by patients. The secondary outcome measures included the improvement rate ofclinical signs assessed by the investigators and the incidence of adverse effects （e.g. clinical candidiasis）. Results A total of 9 RCTs involving 476 patients were finally included. The pooled odds ratio （OR） ofclinical improvement for topical tacrolimus vs. topical corticosteroids was 1.19 [95% confidence interval （CO：0.64-2.22, 12： 44%]. Regarding to 0.1% tacrolimus and 0.03% tacrolimus, the pooled OR were 1.87 （95 % CI：0.60-5.82） and 1.47 （95 % CI： 0.14-16.04） respectively in subgroup analysis. No serious adverse events werereported in topical tacrolimus group. Conclusions There was no evidence to support that topical tacrolimus for EOLP was more effectiveand safer than topical corticosteroids in this Meta-analysis. Clinical assessment criteria should be establishedand accepted by clinicians and researchers before further RCTs are undertaken.