Efficacy of hyaluronidase combined with corticosteroids in treatment of oral submucous fibrosis: a meta‐analysis of randomised controlled clinical trials

OBJECTIVE: This meta-analysis was performed to systematically evaluate the efficacy of hyaluronidase combined with corticosteroids compared with other drugs in improving maximum mouth opening and alleviating the burning sensation in patients with oral submucous fibrosis (OSF). METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched. RevMan 5.3 software was used for the meta-analysis. RESULTS: Six studies involving 244 patients with OSF were analysed. No significant difference in improvement of maximum mouth opening was found between the hyaluronidase and control groups (lycopene, pentoxifylline, aloe vera, dexamethasone, Turmix [curcumin + piperine], and isoxsuprine) at 1 month (mean difference [MD]: 0.32, 95% confidence interval [CI]: -0.92-1.56, P=0.61, I(2) =57%), 2 months (MD: 0.49, 95% CI: -0.14-1.12, P=0.12, I(2) =41%), or 3 months (MD: 0.40, 95% CI: -1.08-1.87, P=0.60, I(2) =92%). Additionally, no statistically significant difference was found in alleviation of the burning sensation between the two groups at 1 month (MD: 0.54, 95% CI: -0.62-1.71, P=0.36, I(2) =0%), 2 months (MD: 0.53, 95% CI: -0.85-1.91, P=0.45, I(2) =0%), or 3 months (MD: 0.64, 95% CI: -1.07-2.35, P=0.46, I(2) =0%). CONCLUSIONS: According to this meta-analysis, weak evidence indicates that hyaluronidase combined with corticosteroids has no additional clinical benefit over control drugs (lycopene, pentoxifylline, aloe vera, dexamethasone, Turmix, and isoxsuprine) in improving maximum mouth opening and alleviating the burning sensation in patients with OSF. Therefore, more high-quality, multi-centre randomised controlled trials with larger samples are needed to further assess the efficacy of hyaluronidase combined with corticosteroids in the treatment of OSF.