Journal of Oral Health and Community Dentistry

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VOLUME 17 , ISSUE 3 ( September-December, 2023 ) > List of Articles


Comparison of the Effectiveness and Safety of Hydroxychloroquine and Methotrexate in the Treatment of Moderate-to-severe Oral Lichen Planus: A Pilot Study

Suboda Gnanarathne, Sanjeewani Fonseka, Supun S Manathunga, Ruwan Jayasinghe, Samadara Siriwardane

Keywords : Hydroxychloroquine, Methotrexate, Oral lichen planus, Randomized clinical trial

Citation Information : Gnanarathne S, Fonseka S, Manathunga SS, Jayasinghe R, Siriwardane S. Comparison of the Effectiveness and Safety of Hydroxychloroquine and Methotrexate in the Treatment of Moderate-to-severe Oral Lichen Planus: A Pilot Study. J Oral Health Comm Dent 2023; 17 (3):116-120.

DOI: 10.5005/jp-journals-10062-0178

License: CC BY-NC 4.0

Published Online: 31-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Aim and the background: Lichen planus (LP) is an autoimmune chronic inflammatory disorder. Oral lichen planus (OLP) affects the mucous membranes of the mouth. Mainstay of treatment is steroids. The aim of this study was to compare the effectiveness and safety of hydroxychloroquine (HCQ) and methotrexate (MTX) with standard treatment (systemic steroids) in the treatment of moderate-to-severe OLP. Materials and methods: The study was conducted as a pilot study of a randomized, open-label, parallel-group, comparison trial assessing the efficacy and safety of systemic steroids (arm A), hydroxychloroquine (arm B), and methotrexate (arm C) in the treatment of moderate-to-severe OLP. Outcome measures were Guy's oral disease severity scoring system (Guy's ODSS) and chronic oral mucosal diseases questionnaire (COMD). Results: Thirty patients between the ages 18 and 60 years with moderate-to-severe OLP completed the study. The reduction of the pain, site, activity, and total score of Guy's ODSS were statistically significant in arm C whereas pain, activity and total score of Guy's ODSS were statistically significant in arm A. Conclusion: This study showed MTX was equally effective as standard treatment (systemic steroid) in the treatment of moderate-to-severe OLP. Therefore, it can be used in place of steroids to minimize the adverse effects of long-term systemic steroids. To see the difference between three arms, larger sample size is needed. Clinical significance: Methotrexate could be considered as an effective treatment for moderate-to-severe OLP without having adverse effects of long-term systemic steroids.

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