Effect of levamisole on treatment of recurrent aphthous stomatitis: A systematic review and meta-analysis

Document Type : Review Article(s)

Authors

1 Associate Professor, Department of Oral Medicine and Orofacial Pain, School of Dentistry, Kerman University of Medical ‎Sciences, Kerman, Iran

2 Oral and Dental Diseases Research Center AND Kerman Social Determinants on Oral Health Research ‎Center, Kerman ‎University of Medical Sciences, Kerman, Iran

3 Dentist, Private Practice, Kerman, Iran

4 Resident, Department of Oral Medicine and Orofacial Pain, School of Dentistry, Kerman University of Medical Sciences, ‎Kerman, Iran

5 PhD Candidate, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, ‎Tehran, Iran

Abstract

BACKGROUND AND AIM: The aim of this study was to systematically analyze the effect of levamisole on treatment of recurrent aphthous stomatitis (RAS).METHODS: An electronic search was executed in PubMed, Cochrane, and Scopus after determining the research question using the appropriate Medical Subject Heading (MeSH) term covering the period from 1975 to 2015. Additional publications from hand searching and the reference section of each relevant article enriched the article list. Finally, 9 articles that have assessed the effect of levamisole on the treatment of RAS and had suitable qualifications for the accomplishment of systematic review and meta-analysis were included.RESULTS: The results showed that the chance of improvement in patients taking levamisole was 6 [odds ratio (OR) = 5.67, 95% confidence interval (CI)] times more than in patients not taking this drug.CONCLUSION: It appears that levamisole is an effective drug for the treatment of RAS, but further appropriate studies should carryout in this context.

Keywords


  1. Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz) 2014; 62(3): 205-15.
  2. Belenguer-Guallar I, Jimenez-Soriano Y, Claramunt-Lozano A. Treatment of recurrent aphthous stomatitis. A literature review. J Clin Exp Dent 2014; 6(2): e168-e174.
  3. Gupta P, Ashok L, Naik SR. Assessment of serum interleukin-8 as a sensitive serological marker in monitoring the therapeutic effect of levamisole in recurrent aphthous ulcers: a randomized control study. Indian J Dent Res 2014; 25(3): 284-9.
  4. Sharma S, Ali FM, Saraf K, Mudhol A. Anti-helminthic drugs in recurrent apthous stomatitis: A short review. J Pharm Bioallied Sci 2014; 6(2): 65-8.
  5. Picciani BL, Silva-Junior GO, Barbirato DS, Ramos RT, Cantisano MH. Regression of major recurrent aphthous ulcerations using a combination of intralesional corticosteroids and levamisole: a case report. Clinics (Sao Paulo) 2010; 65(6): 650-2.
  6. Sharda N, Shashikanth MC, Kant P, Jain M. Levamisole and low-dose prednisolone in the treatment of reccurent aphthous stomatitis. J Oral Pathol Med 2014; 43(4): 309-16.
  7. Luderschmidt C. Treatment of recurrent herpes simplex and recurring stomatitis with levamisol. Z Hautkr 1979; 54(10): 421-3.
  8. Zissis NP, Hatzioti AJ, Antoniadis D, Ninika A, Hatziotis JC. Therapeutic evaluation of levamisole in recurrent aphthous stomatitis. Double-blind comparison of two dosage schedules of levamisole and placebo. J Oral Med 1983; 38(4): 161-3.
  9. Machado JA. Levamisole-a new treatment for two old problems: recurrent aphthous ulceration and recurrent labial herpes simplex. Rev Assoc Paul Cir Dent 1981; 35(1): 20-6.
  10. Dash R, Panda R, Mishra SS, Das PC, Mishra KC. Levamisole in recurrent aphthous stomatitis. J Indian Med Assoc 1983; 80(9-10): 140-1.
  11. Meyer JD, Degraeve M, Clarysse J, De Loose F, Peremans W. Levamisole in aphthous stomatitis: evaluation of three regimens. Br Med J 1977; 1(6062): 671-4.
  12. Gier RE, George B, Wilson T, Rueger A, Hart JK, Quaison F, et al. Evaluation of the therapeutic effect of levamisole in treatment of recurrent aphthous stomatitis. J Oral Pathol 1978; 7(6): 405-13.
  13. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. New York, NY: Wiley; 2008.
  14. Kaplan B, Cardarelli C, Pinnell SR. Double-blind study of levamisole in aphthous stomatitis. J Oral Pathol 1978; 7(6): 400-4.
  15. van de Heyning J. Levamisole in the treatment of recurrent aphthous stomatitis. Laryngoscope 1978; 88(3): 522-7.
  16. Drinnan AJ, Fischman SL. Randomized, double-blind study of levamisole in recurrent aphthous stomatitis. J Oral Pathol 1978; 7(6): 414-7.
  17. de Cree J, Verhaegen H, de Cock W, Verbruggen F. A randomized double-blind trial of levamisole in the therapy of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1978; 45(3): 378-84.
  18. Olson JA, Silverman S. Double-blind study of levamisole therapy in recurrent aphthous stomatitis. J Oral Pathol 1978; 7(6): 393-9.
  19. Lehner T, Wilton JM, Ivanyi L. Double blind crossover trial of levamisole in recurrent aphthous ulceration. Lancet 1976; 2(7992): 926-9.
  20. Miller MF, Silvert ME, Laster LL, Green P, Ship II. Effect of levamisole on the incidence and prevalence of recurrent aphthous stomatitis. A double-blind clinical trial. J Oral Pathol 1978; 7(6): 387-92.
  21. Weckx LL, Hirata CH, Abreu MA, Fillizolla VC, Silva OM. Levamisole does not prevent lesions of recurrent aphthous stomatitis: a double-blind placebo-controlled clinical trial. Rev Assoc Med Bras 2009; 55(2): 132-8.
  22. Sun A, Wang JT, Chia JS, Chiang CP. Levamisole can modulate the serum tumor necrosis factor-alpha level in patients with recurrent aphthous ulcerations. J Oral Pathol Med 2006; 35(2): 111-6.
  23. Sun A, Chia JS, Chang YF, Chiang CP. Levamisole and Chinese medicinal herbs can modulate the serum interleukin-6 level in patients with recurrent aphthous ulcerations. J Oral Pathol Med 2003; 32(4): 206-14.
  24. Brocklehurst P, Tickle M, Glenny AM, Lewis MA, Pemberton MN, Taylor J, et al. Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). Cochrane Database Syst Rev 2012; 9: CD005411.
  25. Taylor J, Brocklehurst P, Glenny AM, Walsh T, Tickle M, Lewis MA, et al. Topical interventions for recurrent aphthous stomatitis (mouth ulcers) (Protocol). Cochrane Database of Systematic Reviews 2013; 12: CD010881.