What do systematic reviews say?

Leukotriene receptor antagonist vs placebo

Montelukast (leukotriene receptor antagonist; 10 mg daily for 1… 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 -3.90 [-4.55, -3.25]
  1 study · 40 participants
  GRADE not reported

Hydrocortisone (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 hydrocortisone for RAS was identified.
  0 studies
  No studies found

Aloe vera gel vs placebo

Aloe vera gel led to higher pain (>=50% improvement in symptoms) compared with placebo; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 6.16 [2.35, 16.13]
  1 study · 45 participants
  GRADE not reported

Levamisole (150 mg per day) vs placebo

Levamisole (150 mg per day) showed no clear difference in decrease in number of ulcers compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  RR 7.88 [0.51, 121.96]
  1 study
  GRADE not reported

Pentoxifylline vs placebo

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

  60 days (plus 60-day follow-up)
  Patients receiving pentoxifylline reported more adverse events than those in the placebo group but this was not statistically significant (69% reported adverse effects: dizziness, headaches, stomach upset, increased…
  1 study · 26 participants
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

Colchicine (0.5 mg per day for 3 months) showed no clear difference in number of aphthous ulcers at completion compared with prednisolone (5 mg per day for 3 months); GRADE not reported.

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

  3 months
  MD -0.13 [-0.50, 0.24]
  1 study · 34 participants
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

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

  3 months
  Colchicine was associated with statistically significantly more adverse effects than prednisolone (nine participants reporting adverse effects on colchicine versus two on prednisolone).
  1 study · 34 participants
  GRADE not reported

Tetracycline suspension (250 mg, held in mouth 2 minutes then swallowed, four times daily for 5 days) vs placebo

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

  5 days per outbreak
  Adverse event rates were comparable between groups.
  1 study
  GRADE not reported

Ciclosporin rinse vs Placebo (vehicle cream)

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  We were unable to extract data on participant-reported symptoms for Eisen 1990 because there was no breakdown of data for the ELP subgroup.
  1 study · 8 participants
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

Colchicine (0.5 mg per day for 3 months) showed no clear difference in recurrence during treatment period compared with prednisolone (5 mg per day for 3 months); GRADE not reported.

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

  3 months
  RR 1.30 [0.98, 1.71]
  1 study · 34 participants
  GRADE not reported

Topical clobetasol propionate 0.025% vs clobetasol cream 0.05% cream

Topical clobetasol propionate 0.025% showed no clear difference in partial response (partial or complete response) compared with topical clobetasol propionate 0.05%; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 1.18 [0.82, 1.70]
  1 study · 35 participants
  GRADE not reported

Tacrolimus 0.1% vs Topical clobetasol propionate 0.05% ointment

Topical tacrolimus 0.1% ointment showed no clear difference in reduction in target/mean lesion size compared with topical clobetasol propionate 0.05% ointment; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  MD 0.00 [-1.09, 1.10]
  1 study · 29 participants
  GRADE not reported

Fluocinonide in adhesive base vs placebo

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Table 3 (Side-effects). Voute 1993: no side-effects during the study and follow-up period.
  1 study · 27 participants
  GRADE not reported

Levamisole 50 mg three times per day for days 1 and 2 vs Levamisole 50 mg three times per day for day 1 and placebo for day 2 (lower dose)

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

  16 weeks
  A trial at high risk of bias (Zissis 1983) compared two different dose regimens of levamisole (treatment 2 days per week for 16 weeks; a third group received placebo). There was inconsistency in the presentation of the…
  1 study
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs Montelukast (leukotriene receptor antagonist)

Prednisone (oral, commencing 25 mg with phased dose reduction over 2… showed no clear difference in total number of new lesions over 2-month treatment period compared with montelukast (leukotriene receptor antagonist); GRADE not reported.

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

  2 months
  MD -0.30 [-0.90, 0.30]
  1 study · 40 participants
  GRADE not reported

Colchicine (0.5 mg three times per day) vs placebo

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

  6 months
  There was a greater percentage of treatment interruptions in the colchicine group due to gastrointestinal adverse effects (Fisher's exact test P=0.009). The review noted potential evidence of harm at a dose of 1.5 mg…
  1 study · 43 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
  No evidence of drug side effects was observed.
  1 study · 93 participants
  GRADE not reported

LongoVital (herbal plus vitamin component) vs LongoVital (herbal component alone)

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

  4 months
  Reported adverse events were minor and evenly distributed between the groups (Kolseth 2005).
  1 study · 40 participants
  GRADE not reported

Topical clobetasol propionate 0.025% vs clobetasol cream 0.05% cream

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Table 3 (Side-effects). Carbone 2009: no side-effects.
  1 study · 35 participants
  GRADE not reported

Clobetasol-17-propionate 0.025% lipid-loaded microspheres vs Clobetasol propionate 0.025% ointment

Clobetasol-17-propionate 0.025% lipid-loaded microspheres led to lower pain reduction (VAS 0-100) compared with conventional 0.025% clobetasol lipophilic ointment in hydrophilic…; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  MD -18.30 [-28.57, -8.03]
  1 study · 45 participants
  GRADE not reported