What do systematic reviews say?

Multivitamin vs placebo

Daily multivitamin showed no clear difference in mean number of new lesions compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  MD -0.41 [-1.85, 1.03]
  1 study
  GRADE not reported

Fluocinonide in adhesive base vs placebo

Fluocinonide in adhesive base showed no clear difference in physician Global Assessment (clinical signs, complete response) compared with placebo; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 4.67 [0.24, 88.96]
  1 study · 27 participants
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

Prednisone (oral, commencing 25 mg with phased dose reduction over 2… led to lower total number of new lesions over 2-month treatment period compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  MD -4.20 [-4.84, -3.56]
  1 study · 40 participants
  GRADE not reported

Camel thorn (plant distillate) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  up to 14 days
  The authors report lower pain and smaller lesions in the camel thorn group up to 10 days after referral; a statistically significant difference in pain intensity was also reported.
  1 study · 93 participants
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  Femiano 2003 (high risk of bias) reports days to resolution of pain and days to epithelialization of aphthae at 1 month, and number of aphthae per month after the first and second months; data presented as…
  1 study · 20 participants
  GRADE not reported

Beta-glucan (1.3/1.6 beta-glucan 10 mg twice daily for 20 days) vs placebo

Beta-glucan (1.3/1.6 beta-glucan 10 mg twice daily for 20 days) led to lower ulcer severity score (USS) compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  20 days
  MD -4.38 [-6.17, -2.59]
  1 study · 31 participants
  GRADE not reported

Camel thorn (plant distillate) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  up to 14 days
  A single trial (Pourahmad 2010, unclear risk of bias) randomised 93 participants to camel thorn distillate (n=49) or placebo (n=44). Mean time to complete resolution was 4.02 days (range 3 to 7) for camel thorn…
  1 study · 93 participants
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  Femiano 2003: one significant adverse event (gastritis) for the prednisone group versus none for placebo. Femiano 2010: more drug-related adverse effects for those treated with prednisone than placebo.
  2 studies
  GRADE not reported

Any topical or systemic intervention (topical/systemic steroids, ciclosporin, tacrolimus, retinoids, anti-malarials, biologics, phototherapy, surgery) vs Placebo, no treatment, another active intervention, or a different dose of the same intervention

The review found no eligible studies for this question.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  None of the included studies assessed the effectiveness of treatments of genital ELP; thus, this outcome was not reported.
  0 studies
  No studies found

Vitamin B12 (sublingual, 1000 mcg daily for 6 months) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 months
  No adverse events were associated with receiving vitamin B12 or placebo in this study.
  1 study · 58 participants
  GRADE not reported

1% pimecrolimus cream vs Placebo (vehicle cream)

1% pimecrolimus cream showed no clear difference in complete clinical response (complete clearance) compared with placebo (vehicle cream); GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 3.50 [0.95, 12.90]
  1 study · 20 participants
  GRADE not reported

LongoVital (herbal component alone) vs placebo

LongoVital (herbal component alone) showed no clear difference in general degree of discomfort compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  4 to 6 months
  MD -0.30 [-0.37, 0.97]
  1 study · 50 participants
  GRADE not reported

Bee propolis (one 500 mg capsule per day) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 months (minimum)
  Propolis was associated with low rates of minimal side effects.
  1 study · 19 participants
  GRADE not reported

Individualised homeopathic medicine (two doses over 24 hours) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 days
  A statistically significant difference was reported in mean pain score and mean ulcer size favouring the homeopathic group (P<0.05). Summary data not presented, precluding further analysis.
  1 study · 100 participants
  GRADE not reported

Subantimicrobial dose doxycycline (20 mg twice daily for 90 days) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  90 days
  No differences in adverse events were reported.
  1 study · 50 participants
  GRADE not reported

Individualised homeopathic medicine (two doses over 24 hours) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 days
  No participant needed to discontinue treatment due to adverse events.
  1 study · 100 participants
  GRADE not reported

1% pimecrolimus cream vs Placebo (vehicle cream)

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  In Passeron 2007 (n=12), all participants who improved during treatment relapsed within 1 month of ceasing treatment.
  1 study · 12 participants
  GRADE not reported

Clofazimine (100 mg daily for 30 days, then 100 mg every other day) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 months
  One trial at high risk of bias compared clofazimine (n=23) with placebo (n=20). The number of individuals in the clofazimine group who had no further aphthous episodes from beginning treatment until completion at 6…
  1 study · 43 participants
  GRADE not reported

LongoVital (herbal component alone) vs placebo

LongoVital (herbal component alone) showed no clear difference in number of days of pain (monthly average) compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  4 to 6 months
  MD -3.80 [-9.39, 1.79]
  1 study · 50 participants
  GRADE not reported

Beclometasone dipropionate (systemic corticosteroid) vs Placebo or no treatment

The review found no eligible studies for this question.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  Table 1: 'Studies of these corticosteroids were not found or included in the review but are included here for completeness.' No trial of beclometasone dipropionate for RAS was identified.
  0 studies
  No studies found