ACTINIC CHEILITIS: A SYSTEMATIC REVIEW OF THE USE OF TOPICAL ANTI-INFLAMMATORY AND ANTINEOPLASTIC AGENTS

Abstract

Objectives A systematic review was conducted to analyze the use of topical agents in the treatment of actinic cheilitis (AC) as well as patient acceptability. Study Design A systematic review of clinical studies was conducted following the patient, intervention, comparision and outcome (PICO) strategy to answer the following question: Are topical anti-inflammatory and antineoplastic agents effective in the treatment of actinic cheilitis? The quality of the studies was assessed by risk of bias-2 tool (ROB-2) and the certainty of evidence was rated by grading of recommendations assessment, development and evaluation (GRADE) guidelines. Results Eight clinical studies were selected: 4 investigated the use of anti-inflammatory drugs and 4 the use of antineoplastic. The use of 3% diclofenac sodium, fludroxycortide 0.125 mg/g, imiquimod 5%, and ingenol mebutate were associated with partial and/or complete remission of AC. Furthermore, 5-fluorouracil 5% was the drug most associated with complications during treatment. Diclofenac sodium (3%) and fludroxycortide showed the best acceptance by patients, especially for symptom relief and less adverse reactions. Conclusions The anti-inflammatory and antineoplastic agents analyzed promoted clinical improvement, with evidence of remission of AC lesions, development of few local adverse reactions during treatment, and good patient adherence. A systematic review was conducted to analyze the use of topical agents in the treatment of actinic cheilitis (AC) as well as patient acceptability. A systematic review of clinical studies was conducted following the patient, intervention, comparision and outcome (PICO) strategy to answer the following question: Are topical anti-inflammatory and antineoplastic agents effective in the treatment of actinic cheilitis? The quality of the studies was assessed by risk of bias-2 tool (ROB-2) and the certainty of evidence was rated by grading of recommendations assessment, development and evaluation (GRADE) guidelines. Eight clinical studies were selected: 4 investigated the use of anti-inflammatory drugs and 4 the use of antineoplastic. The use of 3% diclofenac sodium, fludroxycortide 0.125 mg/g, imiquimod 5%, and ingenol mebutate were associated with partial and/or complete remission of AC. Furthermore, 5-fluorouracil 5% was the drug most associated with complications during treatment. Diclofenac sodium (3%) and fludroxycortide showed the best acceptance by patients, especially for symptom relief and less adverse reactions. The anti-inflammatory and antineoplastic agents analyzed promoted clinical improvement, with evidence of remission of AC lesions, development of few local adverse reactions during treatment, and good patient adherence.