Impact of Topical Fluocinonide on Oral Lichen Planus Evolution: Randomized Controlled Clinical Trial

Oral Dis. 2024 Oct 14. doi: 10.1111/odi.15156. Online ahead of print.

Abstract

Objective: To examine the impact of fluocinonide 0.05% gel formulation for the topical treatment of oral lichen planus (OLP).

Methods: Through an RCT design, 47 patients with OLP were randomly allocated for topical OLP treatment with fluocinonide 0.05% (n = 23) or placebo (n = 24). Patients were examined for OLP symptoms, signs, disease severity, and extension score changes over 6-month follow-up.

Results: After 6 months, in comparison with placebo, patients treated with fluocinonide experienced a significant reduction of OLP symptoms (p = 0.024), signs (p = 0.014), and OLP extension score (p = 0.028). The two-way ANOVA estimation models revealed that treatment with fluocinonide determined, at 6 months, a positive significant effect on the reduced OLP signs (p = 0.017), OLP symptoms (p = 0.026), and OLP extension score (p = 0.028). The multivariate regression analysis highlighted that anxiety, stress, and depression were significant predictors of every analyzed OLP outcome (p < 0.05 for each parameter) and that patients who had baseline anxiety, depression, and stress gained more benefits from fluocinonide at 6-month follow-up.

Conclusions: Topical fluocinonide 0.05% was more efficacious compared to placebo in reducing OLP outcomes at 6-month follow-up. Anxiety, depression, and stress were significant predictors of OLP outcomes and positively impacted the treatment with fluocinonide at 6 months.

Keywords: anxiety; clinical study; depression; fluocinonide; oral lichen planus; oral mucosa; randomized clinical trial; stress; treatment.