Oral Lichen Planus Clinical Trial
Official title:
A 6-week Randomized, Double-blind, Vehicle-controlled Pilot Study With a 6-week Open Label Extension to Assess the Efficacy and Safety of Pimecrolimus 1% Cream in the Treatment of Oral Lichen Planus
Study investigating the use of pimecrolimus 1% cream for oral lichen planus
Lichen planus (LP) is an idiopathic inflammatory dermatosis of the skin and mucous
membranes. Cutaneous lesions present as pink polygonal papules on the flexor wrists, trunk,
thighs, shin and the dorsal hands. Oral lichen planus (OLP) represents a unique subset of LP
and is often the sole manifestation of this disease. Clinically, the lesions can be
reticulate, erythematous, atrophic or erosive, with the erosive form being the most common.
Lesions can be found anywhere in the oral mucosa and are associated with burning pain which
is worsened while eating. The risk of development of squamous cell carcinoma has been
estimated to be as high as 5%. Treatments for oral lichen planus involve high potency
topical steroid, systemic steroids, oral/topical retinoids and immunosuppressants. However,
the long term side effects of steroids (e.g. striae, skin atrophy, telangiectasias,
tachyphylaxis, secondary candidiasis and perioral dermatitis) prevent more extensive
utilization except in the most severe cases. Given the debilitating nature of OLP, risk of
malignant transformation, and long term side effects associated with current therapies, a
safe intervention is needed for this disorder.
Tacrolimus and pimecrolimus may have fewer side affects than topical steroids. Recently, in
an open label trial of 19 patients with recalcitrant erosive lichen planus, tacrolimus
decreased the area of ulceration by 73% after an eight week course. Local irritation was the
most common side effect. However, tacrolimus comes in an ointment base, a poorly tolerated
vehicle for oral lesions. Topical treatment of oral lesions has also been compromised by
problems with maintaining sufficient contact time between poorly adherent cream and ointment
preparations and moist mucous membrane surfaces.
This study is designed to evaluate the topical application of pimecrolimus 1% cream when
applied twice daily with occlusion in the treatment of oral lichen planus.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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