Oral Lichen Planus, Oral Lichen Planus Related Stress, Oral Mucosal Disease, Oral Pain
Conditions
Keywords
mucoadhesive patch, oral lichen planus, clobetasol, resveratrol, drug delivery system, Optical coherence tomography, Ora pain
Brief summary
The goal of this clinical trial is to learn if a mucoadhesive patch containing clobetasol alone or in combination with resveratrol can reduce symptoms and improve quality of life in adults with Oral Lichen Planus (OLP). The main questions it aims to answer are: Does the patch reduce oral pain and burning sensations? Does it improve the appearance of oral lesions and patients' daily well-being? Researchers will compare: A patch containing clobetasol A patch containing clobetasol and resveratrol A standard clobetasol 0.05% ointment in an adhesive base Participants will: Apply their assigned treatment to the oral lesion daily for 30 days Attend three clinical visits for evaluations and imaging Complete questionnaires about pain, symptoms, and treatment experience
Detailed description
Oral Lichen Planus (OLP) is a chronic inflammatory condition affecting the oral mucosa, often causing painful lesions, burning sensations, and impaired quality of life. Current treatments primarily rely on high-potency topical corticosteroids, such as clobetasol propionate. However, conventional formulations like ointments or pastes may be difficult to apply, poorly retained in the oral cavity, and associated with limited bioavailability or side effects. This clinical trial investigates the efficacy of a novel mucoadhesive drug delivery system in the form of a patch. The patch is designed to adhere to the oral mucosa, releasing the active compounds in a controlled and prolonged manner. Two types of patches are tested: one containing clobetasol propionate alone and one containing a combination of clobetasol and resveratrol, a natural polyphenol known for its anti-inflammatory and immunomodulatory properties. The study is a triple-blind, randomized, controlled clinical trial conducted on adult patients with a confirmed histological diagnosis of symptomatic OLP. Participants are randomly assigned to one of three arms: Arm 1: Patch with clobetasol propionate Arm 2: Patch with clobetasol propionate and resveratrol Arm 3 (Control): Clobetasol 0.05% in an orabase-type adhesive paste Treatments are applied over a 30-day period following a standardized schedule. Clinical evaluations take place at baseline, 15 days, and 30 days, and include photographic documentation, symptom scoring with the Visual Analog Scale (VAS), and clinical severity assessment using the Thongprasom score. In addition, participants complete the Oral Health Impact Profile-14 (OHIP-14) questionnaire to evaluate changes in oral-health-related quality of life. Structural changes in the mucosa are monitored using Optical Coherence Tomography (OCT), a non-invasive imaging technique that allows real-time visualization of tissue layers, providing objective information on epithelial healing and inflammation. The primary outcomes are reduction in pain and burning symptoms, improvement of lesion severity, and increased quality of life. Secondary outcomes include patient compliance and OCT-based structural improvement. This study aims to offer a more effective, better tolerated, and innovative therapeutic approach for managing oral lichen planus.
Interventions
A mucoadhesive patch containing clobetasol propionate 0.05%. Applied once daily for 30 days to the oral lesion.
A mucoadhesive patch containing clobetasol propionate 0.05% and resveratrol. Applied once daily for 30 days to the oral lesion.
Clobetasol propionate 0.05% in orabase-type adhesive paste. Applied once daily for 30 days to the oral lesion.
Sponsors
Study design
Intervention model description
Model Description: Triple-arm, parallel assignment model with 1:1:1 randomization. Each participant is randomly assigned to one of three intervention groups receiving either: (1) a mucoadhesive patch with clobetasol, (2) a mucoadhesive patch with clobetasol and resveratrol, or (3) clobetasol 0.05% in an orabase-type paste.
Eligibility
Inclusion criteria
* Adults aged 18 years or older. * Clinical suspicion of Oral Lichen Planus (OLP). * Histological confirmation of OLP based on World Health Organization (WHO) criteria (presence of hyperkeratosis, acanthosis, basal cell degeneration, and a band-like lymphocytic infiltrate in the lamina propria). * Absence of epithelial dysplasia. * Ability to understand and sign informed consent.
Exclusion criteria
* Previous diagnosis or treatment for OLP. * Use of topical or systemic corticosteroids in the last 4 weeks. * Use of medications known to cause lichenoid reactions. * History of allergic reactions to dental materials (e.g., amalgam). * Hematological disorders or immunodeficiencies. * Pregnancy or breastfeeding. * Current use of immunosuppressive therapies. * Inability or unwillingness to comply with study procedures.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Symptom Intensity (Pain/Burning) | Baseline and Day 30 | Patient-reported pain and burning intensity will be measured using the 10-point Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate worse symptoms. |
| Change in Clinical Severity of Lesions | Baseline and Day 30 | Clinical improvement will be assessed using the Thongprasom clinical scoring system (score range 0-5, where 0 = no lesion and 5 = severe erosive lesion). Higher scores indicate worse lesion severity. The outcome will measure the change from baseline to day 30. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Oral Health-Related Quality of Life | Baseline and Day 30 | Evaluated using the Oral Health Impact Profile-14 (OHIP-14) questionnaire (range 0-56, with higher scores indicating worse quality of life). |
| Compliance with Treatment | Day 15 and Day 30 | Adherence to the patch protocol, measured as the number of daily applications recorded in participant diaries. |
| Epithelial Structural Improvement (OCT Imaging) | Baseline and Day 30 | Changes in mucosal architecture will be assessed using Optical Coherence Tomography (OCT). Improvement is defined as reduction in epithelial discontinuities and inflammatory patterns. |
Countries
Italy