Effect of mucoadhesive from of Mycophenolate Mofetil on oral erosive lichen planus lesions

Abstract

Oral Lichen Planus (OLP) is a chronic inflammatory disease of unknown etiology. Specially, the erosive (ulcerative) form of OLP is known as a premalignant disease. However, a complete cure has not been found for it. Mycophenolate Mofetil(MMF) is a new drug that seems to be effective in improvement of OLP lesions . In dermatology , success of oral MMF has been reported in case and pilot studies in therapy of pemphigus, pemphigoid, CrohnEs disease, psoriasis, lupus erythematosus and cutaneous erosive lichen planus. But there are no studies about efficacy of mucoadhesive form of MMF in ulcerative OLP. So this study was performed to determine therapeutic effect of MMF mucoadhesive in ulcer size and severity of burn and pain of OLP lesions in patients. Methods: In this clinical trial study, 27 patients with OLP ,referred to Oral Medicine Department of Tabriz Dental School; were enrolled. 10 patients had bilateral ulcerative lesions of OLP and they were enrolled in a double blind clinical trial study (group A). 17 patients which had unilateral ulcerative lesion of OLP, were enrolled in a before-after clinical trial study (group B). In group A, patients were instructed to put 2% MMF mucoadhesive on one of the dried lesions and put the placebo on the other one, twice daily for 4 weeks. In group B, patients only used 2% MMF mucoadhesive in the same manner. Size of lesions was measured by digital caliper and the severity of burn and pain by VAS(Visual Analogue Scale), in the initial and each week of the treatment. Data were analyzed with paired t-test, using SPSS v.16 software. Results: In group A, at the end of the treatment (week 4), there were significant differences in pain and burn reduction (P value=0/012) and lesionEs size reduction (P value=0/004) in case sides and also in pain and burn reduction of control sides (P value=0/048). But the difference in lesion size of control sides was not significant (P value=0/216). In group B, at week 4, there were significant differences in pain and burn reduction (P value=0/004) and lesionEs size reduction (P value=0/002).There were no significant differences in burn and lesionEs size reduction at weeks 1, 2 and 3 in both of the groups. No side effects were reported by the patients. Conclusion: 2% MMF mucoadhesive is effective in reduction of burn and pain and ulcer size of ulcerative OLP and this effect is time dependent