{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T21:13:49Z","timestamp":1785532429902,"version":"3.56.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Oral lichen planus (OLP) is a chronic inflammatory condition with malignant potential for oral squamous cell carcinoma (OSCC). Differential risks of pharmacological treatments, particularly long-term use, remain unclear. We aimed to quantify OSCC risk across treatment modalities and assess potential benefit of combining immunosuppressive and anti-inflammatory agents to inform safer strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a large, retrospective cohort study with propensity score matching to balance demographic and clinical covariates. Patients with OLP treated with either systemic or topical glucocorticoids, calcineurin inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), or combinations were followed. OSCC incidence rates were compared between treatment groups, controlling for confounders and stratifying by route and duration of therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with glucocorticoid regimens, calcineurin inhibitors were associated with higher OSCC risk (glucocorticoids: HR 1.85, 95% CI 1.48\u20132.32; calcineurin inhibitors: HR 3.17, 1.48\u20136.76). The lowest risk was seen with topical glucocorticoids. Concomitant NSAIDs, particularly ketorolac and diclofenac, with topical glucocorticoids or calcineurin inhibitors, reduced OSCC risk (topical glucocorticoids: HR 0.73, 0.58\u20130.91; plus ketorolac: HR 0.63, 0.38\u20131.04; topical calcineurin inhibitors alone: HR 1.53, 1.03\u20132.28; plus ketorolac: HR 0.28, 0.15\u20130.54). Owing to retrospective design and reliance on ICD-10 coding, residual confounding and misclassification cannot be excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Calcineurin inhibitors carry high risk for malignant transformation in OLP, while topical glucocorticoids, especially NSAID\/glucocorticoid combinations, offer safer profiles. These findings call for re-evaluation of treatment guidelines and prospective trials assessing novel or combination therapeutics that optimize long-term safety and symptom control in OLP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1752108","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T06:47:10Z","timestamp":1770706030000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of non-steroidal anti-inflammatory drugs on malignant transformation in oral lichen planus: insights from a real-world cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Christian","family":"Seebauer","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery \/ Plastic surgery, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"Center for Clinical Plasma Research and Therapy, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Institute of Experimental Dermatology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"Department of Dermatology, Allergy, and Venerology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"Comprehensive Center for Inflammation Medicine, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Sieg","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery \/ Plastic surgery, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Olbrich","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Allergy, and Venerology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Curman","sequence":"additional","affiliation":[{"name":"Institute of Experimental Dermatology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"Dermato-Venereology Clinic, Karolinska University Hospital","place":["Stockholm, Sweden"]},{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet","place":["Stockholm, Sweden"]},{"name":"Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet","place":["Stockholm, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S25.e1","DOI":"10.1016\/j.tripleo.2006.11.001","article-title":"Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations","volume":"103","author":"Al-Hashimi","year":"2007","journal-title":"Oral Surg. 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