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Efficacy of intralesional injections of platelet-rich plasma in patients with oral lichen planus: A pilot randomized clinical trial
Hijazi A, Ahmed W, Gaafar S
Clinical and experimental dental research. 2022
Abstract
OBJECTIVE To evaluate the clinical efficacy of intralesional platelet-rich plasma (PRP) injections compared to intralesional triamcinolone acetonide (TA) injections in the treatment of erosive oral lichen planus (EOLP). MATERIAL AND METHODS Twenty patients with EOLP were assigned randomly to either PRP or TA group. Patients received weekly intralesional injections for 4 weeks, and then followed up for 3 months on regular visits every 2 weeks. Pain scores using numerical pain score and clinical score were recorded by a blinded assessor each visit for all patients and remission score at the end of the trial was recorded. RESULTS Both groups showed significant improvement in the clinical parameters (pain and clinical score) "p = .001." Regarding remission of the lesions, 80% of patients in the PRP group showed complete remission compared to 70% in the TA group. However, there is no statistical significance when comparing the two groups in pain score, clinical score, or remission. CONCLUSIONS PRP injections could be considered as an effective alternative single treatment modality for EOLP. The protocol for this study registered in Clinicaltrials.gov registry under the identifier number: NCT03293368.
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2.
The efficacy of injectable platelet-rich fibrin in the treatment of symptomatic oral lichen planus
Al-Hallak N, Hamadah O, Mouhamad M, Kujan O
Oral diseases. 2022
Abstract
OBJECTIVES The use of autologous platelet concentrates has shown growing evidence as a promising therapy. We conducted a split-mouth study to evaluate the effectiveness of injectable platelet-rich fibrin (PRF) compared to triamcinolone acetonide (TA) in the treatment of oral lichen planus (OLP). MATERIALS AND METHODS This split-mouth randomized trial included twelve patients with symptomatic, bilateral OLP lesions. The participants were randomly allocated to receive a 1-mL intralesional PRF injection on one side of the buccal mucosa and a 0.5-mL TA injection on the counterpart side. The application was performed once a week for 4 weeks. The outcomes were measured using a visual analog scale score, REU score, and lesion areas. RESULTS Both injectable TA and PRF were effective in the management of oral lichen planus. After four weeks of treatment, there was an average reduction in the VAS score (68.5% i-PRF, 91% TA) and an average reduction in the REU score (74% i-PRF, 91% TA). There were no statistically significant differences between the two treatment methods (P > 0.05). CONCLUSIONS Intralesional injection with TA showed more effectiveness than i-PRF in the management of OPL lesions. Although, i-PRF cannot be considered a first-line treatment option, it showed promising alternative therapy choice with no side effects.
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3.
Evaluating the Efficacy of Intra-articular Injections of Platelet Rich Plasma (PRP) in Rheumatoid Arthritis Patients and its Impact on Inflammatory Cytokines, Disease Activity and Quality of Life
Saif, D. S., Hegazy, N. N., Zahran, E. S.
Current Rheumatology Reviews. 2021;17(2):232-241
Abstract
BACKGROUND Among rheumatoid arthritis patients (RA), general disease activity is well regulated by disease-modifying anti-rheumatic medications (DMARDS), but sometimes local inflammation still persists among a few joints. Adjuvant modern molecular interventions as Platelet Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a proven effect in the management of RA. We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and their impact on inflammatory cytokines IL1B, TNF α, local joint inflammation, disease activity and quality of life (QL). METHODS Open-labeled parallel randomized control clinical trial was carried out on 60 RA patients randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections of PRP at a monthly interval, Group 2: included 30 patients received single intra-articular injection of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline and at 3, and 6 months post injection. RESULTS Patients of both groups showed improvements in their scores of evaluating tools at 3months post injection and this improvement was persistent in the PRP group up to 6 months post injection while it was continued only for 3 months in the steroid group. CONCLUSION PRP is a safe, effective and useful therapy in treating RA patients who had an insufficient response and persistent pain and inflammation in just one or two joints through its down regulating effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint inflammation, disease activity and QL.
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4.
Efficacy of injectable platelet-rich fibrin in the erosive oral lichen planus: a split-mouth, randomized, controlled clinical trial
Saglam, E., Ozsagir, Z. B., Unver, T., Alinca, S. B., Toprak, A., Tunali, M.
Journal of Applied Oral Science : Revista Fob. 2021;29:e20210180
Abstract
OBJECTIVE Our study compared the effects of injectable platelet-rich fibrin (i-PRF) with those of corticosteroids in the treatment of erosive oral lichen planus (EOLP). METHODOLOGY This split-mouth study included 24 individuals diagnosed histopathologically with bilateral EOLP. One bilateral lesion was injected with i-PRF, whereas the other was injected with methylprednisolone acetate in four sessions at 15-day intervals. Visual analog scale (VAS) for pain and satisfaction, oral health impact profile scale-14, and the lesion size were used. RESULTS The intragroup comparisons showed a significant decrease in VAS-pain and lesion size in both the i-PRF group (from 81.88±17.74 to 13.33±18.34, and from 4.79±0.41 to 1.88±1.08, respectively) and the corticosteroid group (from 80.21±17.35 to 23.33±26.81, and from 4.71±0.46 to 2.21±1.35, respectively) in the 6th month compared to baseline (p<0.001). Moreover, VAS-satisfaction increased significantly in both the i-PRF group (from 26.67±17.8 to 85.63±16.24) and the corticosteroid group (from 28.33±17.05 to 74.38±24.11) in the 6th month compared to baseline (p<0.001). However, no significant difference in any value occurred in the intergroup comparisons. CONCLUSION In patients with EOLP, both methods decreased pain and lesion size similarly, and both increased satisfaction. Therefore, the use of i-PRF may be considered an option in cases refractory to topical corticosteroid therapy. Biochemical and histopathological studies are required to reveal the mechanism of i-PRF action in EOLP treatment.
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5.
Efficacy of platelet-rich fibrin compared with triamcinolone acetonide as injective therapy in the treatment of symptomatic oral lichen planus: a pilot study
Bennardo F, Liborio F, Barone S, Antonelli A, Buffone C, Fortunato L, Giudice A
Clinical oral investigations. 2021
Abstract
OBJECTIVES Oral lichen planus (OLP) is a chronic immune-mediated disease that affects the oral cavity. Topical steroids are considered the treatment of choice for painful lesions of OLP. The aim of this split-mouth study was to compare the efficacy of platelet-rich fibrin (PRF) and triamcinolone acetonide (TA) injective therapies in patients with symptomatic OLP. MATERIALS AND METHODS Participants with symptomatic OLP were recruited in the Academic Hospital of Magna Graecia University of Catanzaro, Italy. Once a week for a month, patients randomly received a 0.5-mL TA injection in one buccal mucosa and 1-mL PRF injection in the opposite side. The measured outcomes were reduction of the lesions area and symptomatology modifications using visual analogue scale (VAS) score RESULTS Four weeks after the last injections, an average reduction of 59.8% in the lesion extension and an average reduction of 47.6% in the VAS score for PRF-treated sites were observed; the same variation for TA-treated sites was respectively of 59.2% and 40%. There were no statistically significant differences between the two groups. CONCLUSIONS PRF was effective in reducing OLP lesions extension and symptomatology, and it seems to be as effective as TA. Additional data should be collected with a larger sample size, at a longer follow-up and on the PRF lowest effective dose. CLINICAL RELEVANCE Current treatment options for OLP are limited. The study proved benefits of PRF injections in management of painful lesions of OLP comparable with TA.
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6.
Comparative evaluation of effectiveness of autologous platelet rich plasma and intralesional corticosteroids in the management of erosive oral Lichen planus- a clinical study
Sethi Ahuja U, Puri N, More CB, Gupta R, Gupta D
Journal of oral biology and craniofacial research. 2020;10(4):714-718
Abstract
PURPOSE Oral Lichen planus is a potentially malignant autoimmune disorder, characterized by burning and pain in the affected mucosa which reduces the quality and comfort of patient's life. Various treatment modalities have been documented for OLP but due its malignant potential the alternative therapeutic approaches with least or no side effects are being in demand. One of such, yet unexplored treatment is Platelet rich plasma (PRP). This study aims to evaluate the effectiveness of intralesional PRP as compared to the Intralesional corticosteroids in the management of erosive OLP. MATERIALS AND METHODS The study sample consisted of 20 clinically and histopathologically confirmed patients of Erosive OLP among which 10 patients were given intralesional corticosteroids and 10 patients were administered intralesional PRP. All the patients were given weekly injections for 2 months and were followed up till 4 months for assessing the parameters such as pain/burning, erythema and size of the lesions. RESULTS The patients in both the groups showed a statistically significant reduction in all the assessed parameters of erosive lichen planus from baseline till 4 months of treatment and follow up. However, on comparison of the pain reduction, size of lesion and erythema scores between the two groups, the difference was found to be statistically insignificant. CONCLUSION The intralesional PRP was found to be of comparative effectiveness with respect to intralesional triamcinolone acetonide in the management of erosive OLP and with an added advantage of having less recurrence and no adverse effects.
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7.
A prospective, randomized, controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers
Driver VR, Hanft J, Fylling CP, Beriou JM, Autologel Diabetic Foot Ulcer Study Group
Ostomy/Wound Management. 2006;52((6):):68-70, 72, 74 passim.
Abstract
Nonhealing diabetic foot ulcers are a common cause of amputation. Emerging cellular therapies such as platelet-rich plasma gel provide ulcer management options to avoid loss of limb. The purpose of this prospective, randomized, controlled, blinded, multicenter clinical study was to evaluate the safety and efficacy of autologous platelet-rich plasma gel for the treatment of nonhealing diabetic foot ulcers. One hundred, twenty-nine (129) patients were screened; 72 completed a 7-day screening period and met the study inclusion criteria. Patients were randomized into two groups - the standard care with platelet-rich plasma gel or control (saline gel) dressing group - and evaluated biweekly for 12 weeks or until healing. Healing was confirmed 1 week following closure and monitored for another 11 weeks. An independent audit led to the exclusion of 32 patients from the final per-protocol analysis because of protocol violations and failure to complete treatment. In this group, 13 out of 19 (68. 4%) of the platelet-rich plasma gel and nine out of 21 (42. 9%) of the control wounds healed. After adjusting for wound size outliers (n = 5), significantly more platelet-rich plasma gel (13 out of 16, 81. 3%) than control gel (eight out of 19, 42. 1%) treated wounds healed (P = 0. 036, Fisher's exact test). Kaplan-Meier time-to-healing also was significantly different between groups (log-rank, P = 0. 0177). No treatment-related serious adverse events were reported and bovine thrombin used in the preparation of PRP did not cause Factor V inhibition. When used with good standards of care, the majority of nonhealing diabetic foot ulcers treated with autologous platelet-rich plasma gel can be expected to heal.
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8.
Absence of HBV, HCV, HTLV and HHV-8 activation by allogeneic RBC transfusion of AIDS patients
Asmuth DM, Kalish LA, Laycock ME, Murphy EL, Mohr BA, Lee T,, et al.,
Transfusion. 2002;42((9S):):23S.. Abstract No. S81-040C.
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9.
The influence of a partially HLA-matched blood transfusion on the disease activity of rheumatoid arthritis
van der Horst-Bruinsma IE, Huizinga TW, Lagaay EM, Hazes JM, Breedveld FC, Schreuder GM, Tomson TA, Zwinderman AH, van Rood JJ, de Vries RR
Rheumatology. 1999;38((1):):53-8.
Abstract
OBJECTIVE Based on the immunosuppressive effects of blood transfusions in organ transplantation, we determined the effect of a blood transfusion on disease activity of rheumatoid arthritis (RA). METHOD In this double-blind pilot study, 40 patients with active RA were randomly assigned to receive a HLA-DRB1-matched blood transfusion (n = 30) or placebo (n = 10). Disease activity was scored according to the American College of Rheumatology response criteria during 6 months of follow-up. RESULTS After 1 month and 6 months, respectively, 6 and 16% of patients fulfilled the response criteria in the blood transfusion group compared to none and 30%, respectively, in the placebo group. Following correction for the increase in haemoglobin levels, a majority of the response parameters in the blood transfusion group showed significant improvement compared to the placebo group. CONCLUSION A DRB1-matched blood transfusion shows improvement of symptoms in several RA patients. Additional studies are required to identify blood transfusion regimens that enhance the potential for therapeutic responses.
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10.
Virological and immunological data of AIDS patients treated by passive immunotherapy (transfusions of plasma rich in HIV-1 antibodies)
Morand JL, Vittecoq D, Roudot TF, Mariotti M, Lefrere F, Heshmati F, Audat F, Lambin P, Barre-Sinoussi F, Lefrere JJ
Vox Sanguinis. 1997;73((3):):149-154.