Systemic absorption of 0.1% triamcinolone acetonide as topical application in management of oral lichen planus

Indian J Dent Res. 2016 May-Jun;27(3):230-5. doi: 10.4103/0970-9290.186237.

Abstract

Context: Topical corticosteroids are the treatment of choice for oral lichen planus (OLP) due to its potential anti-inflammatory effect. However, chronic nature of OLP often requires long-term and frequent applications, exposing patients to local and systemic side effects.

Aim: To detect the systemic absorption of 0.1% triamcinolone acetonide (TAC) through the oral mucosa of patients with OLP.

Subjects and methods: This was a pilot pharmacokinetic study carried out in the Department of Oral Medicine and Radiology in collaboration with the Department of Toxicology, over 10 months. A total of twenty patients with OLP were included and advised to apply 0.1% TAC 3 times/day for 2 weeks and 2 times/day for next 2 weeks. Blood samples were obtained on the first and second visits and analyzed for triamcinolone using High pressure liquid chromatography (HPLC).

Statistical analysis used: Paired t-test was done to compare visual analog scale (VAS) score for burning sensation at the first and second visits, statistically significant if P < 0.05. The baseline demographic data were analyzed using descriptive statistics.

Results: Paired t-test was done to compare VAS score for burning sensation at the first and second visits, which turned to being statistically significant (P = 0.001). Although HPLC is an established method for the detection of TAC, none of the study populations showed evidence of steroid (TAC) in the blood sample during 4 weeks of treatment duration.

Conclusions: 0.1% triamcinolone is a relatively safe drug to be used with no systemic absorption in the standard dose regimen for oral lichen palnus.

MeSH terms

  • Absorption, Physiological
  • Administration, Topical
  • Adult
  • Chromatography, High Pressure Liquid
  • Female
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / pharmacokinetics*
  • Humans
  • Lichen Planus, Oral / drug therapy*
  • Male
  • Middle Aged
  • Pain Measurement
  • Pilot Projects
  • Treatment Outcome
  • Triamcinolone Acetonide / administration & dosage*
  • Triamcinolone Acetonide / pharmacokinetics*

Substances

  • Glucocorticoids
  • Triamcinolone Acetonide