The effect of antiresorptive therapy on the prevalence and severity of oral lichen planus: a retrospective study

TL;DR

This study found that patients on antiresorptive therapy are more likely to experience a painful, erosive form of oral lichen planus.

Contribution

This is the first study to show a link between antiresorptive drugs and increased prevalence of erosive oral lichen planus.

Findings

Erosive oral lichen planus was significantly more common in patients on antiresorptive therapy.

Alendronic acid was the most frequently reported antiresorptive drug associated with erosive oral lichen planus.

Erosive oral lichen planus was linked to more severe symptoms like pain and burning sensation.

Abstract

Antiresorptive therapy (AR) disrupts osseous homeostasis and can induce direct irritation over the gastrointestinal mucosa; however, its possible erosive effects on the oral epithelium have not been totally described. Among the most frequent oral erosive lesions, oral lichen planus (OLP) frequently presents as painful mucosal ulcerations, arising from basal membrane inflammatory damage. Thus, the aim of this retrospective study was to describe the association between AR and the incidence of OLP.

This case-control study included data from 148 patients (17 patients undergoing AR therapy (AR group) / 131 without AR therapy (Control group)). Each patient record was systematically processed and the association between AR drugs and OLP clinical characteristics within both groups was assessed.

The erosive form of OLP was significantly more frequent in the AR group than in the Control group (p = 0.029). Indeed, the AR treatment using alendronic acid (41.2%) was the most frequently reported. Additionally, the erosive form of OLP showed the strongest association with pain and burning sensation among the OLP types (p < 0.050). However, disease worsening and AR consumption were not significantly associated (p = 0.150).

Patients under AR therapy show more clinical symptoms associated to the erosive type of OLP. Regardless of the AR therapy, the erosive type of OLP is associated with more severe symptoms.

The online version contains supplementary material available at 10.1186/s12903-024-04331-5.

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