Colchicine in the Management of Oral Submucous Fibrosis - A Systematic Review and GRADE Assessment

Background and Objectives:Oral submucous fibrosis (OSMF) is a chronic oral potentially malignant disorder affecting the oral mucosa. The habit of areca nut chewing is established to be the causative factor. Various treatment modalities are available for managing OSMF. Colchicine obtained from plants of the Colchicum genus can downregulate collagen synthesis and upregulate collagenolytic activity, thereby establishing its antifibrotic property. Hence, the objective of the current study is to assess the efficacy of colchicine in the treatment of OSMF.Methods:A comprehensive search was conducted in MEDLINE via PubMed, Cochrane, ProQuest, Ovid, and Google Scholar, and the clinical trials evaluating the efficacy of oral colchicine for the treatment of OSMF were included. The Cochrane risk of bias tool and GRADE were utilized for assessing the quality.Results:Three clinical trials (one randomized and two non-randomized trials) comprising 110 OSMF patients followed the eligibility criteria. The follow-up time for the patients was between 3 and 6 months. Mouth opening and burning sensation were the primary outcomes of interest. The risk of bias was found to be high in the studies included. GRADE quality assessment showed moderate quality for one study and two studies to be of low-quality evidence.Conclusion:This review suggests that oral colchicine is efficacious in the management of OSMF and more distinctly in improving mouth opening. Considering the significant side effects from conventional treatment for OSMF, colchicine can be an effective modality in improving burning sensation and mouth opening in patients with OSMF.