- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06758739
Comparison of Curcumin and Intralesional Steroids in Oral Submucous Fibrosis
The goal of this clinical trial is to learn if Curcumin is better than Intralesional Steroid Injection for the treatment of oral submucous fibrosis. The main question it aims to answers are:
- If Curcumin is more effective to improve burning sensation as compared to Intralesional steroid.
- Does Curcumin treatment results in better mouth opening versus Intralesional steroid.
- Can Curcumin helps to improve tongue protrusion as compared to Intralesional steroids.
Participants will be:
- Assessed for one month, two month and three month.
- Burning Sensation will be assessed with visual analogue scale (VAS).
- Mouth Opening will be measured in mm with ruler.
- Tongue Protrusion will be assessed with the visual analogue scale (VAS).
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Objective:
To compare the efficacy of Curcumin versus Intralesional steroids in term of burning sensation, mouth opening and tongue Protrusion
Hypothesis:
Curcumin is more effective in terms of burning sensation, mouth opening (interincisal distance) and tongue Protrusion as compared to intralesional steroids.
Operational Definitions:
Oral submucous fibrosis is chronic, slowly progressive precancerous condition caused by areca nut characterized by restricted mouth opening, burning sensation, stiffness and blanching of mucosa and limitation of tongue Protrusion9. It will be clinically assessed as difficulty in mouth opening, burning sensation, fibrous bands & blanching of mucosa along with limited tongue movement.
Efficacy:
Efficacy of Curcumin & intralesional steroids will be assessed in terms of burning sensation VAS score, mouth opening & Tongue Protrusion
Burning Sensation:
A burning sensation in oral submucous fibrosis is often due to tissue changes, dryness, nutritional deficiencies, or secondary infections affecting the oral mucosa. Patient feels pain or discomfort in mouth especially when eating hot or spicy food Patient will be asked for burning sensation & based on severity numerical score given by VAS (Visual Analog Scale) (Bohra et al.)9
Mouth Opening:
Mouth opening is progressively restricted due to fibroses and stiffness of oral tissue. It will be measured in mm. Patient will be asked to open mouth as wide as he/she can & with the help of mental scale & divider (Vernier caliper) between maxillary incisor & mandibular incisor9.
Tongue Protrusion:
Tongue Protrusion in oral submucous fibrosis refers to the difficulty or inability to fully move the tongue out of the mouth due to stiffness and restricted mobility caused by fibrotic changes in the oral tissues. It will be assessed from normal mesio-incisal angel of maxillary central incisor to the tip of tongue when maximally extended with wide mouth open (Ramesh et al.)11
Material and Methods:
Study Design:
Randomized Central trial (RCT)
Study Setting:
Department of Oral & Maxillofacial surgery, Services Institute of Medical Sciences Lahore
Duration of Study:
Six months
Sample Size: A sample size will be of 70 patients (35 in each group). Calculated using the expected mean difference of burning sensation VAS score between curcumin group and intralesional steroids inj.
Sampling Technique:
Non-probability purposive sampling technique.
Sample Selection:
Inclusion Criteria:
Patients diagnosed with Oral submucous fibrosis in accordance with operational definition.
Male & Female
Exclusion Criteria:
Patient unable to quit the habit of gutkha, tobacco & betel nut chewing Patient With uncontrolled diabetes Patient with chronic kidney disease Pregnant female Patient with untreated malignancy/taking immunosuppressant drugs Patient with H/O ORAL SUBMUCOUS FIBROSIS in last months
Data Collection Procedure:
All eligible patients undergoing oral submucous fibrosis treatment will be invited to participate in the study and informed consent will be obtained from all the volunteer participants. Total 70 (35 in each group) will be randomized into two equal size groups i.e. Group A and B by using online computer-generated program which concealed randomization and treatment allocation. A structured Proforma will be used to call demographic and clinical data. Before treatment, baseline burning sensation, mouth opening (interincisal distance) and tongue Protrusion will be noted. In group A, Patient will receive Curcumin Capsule (nutrifactor) 2 per day for 3 months. In group B, Patient will receive intralesional steroid injection 4mg/1cc weekly for 3 months. Participants health care provider, data collector and outcome assessors will be blinded to the treatment allocation. Patient will be assessed for burning sensation, INTERINCISAL DISTANCE & tongue protrusion monthly. As per operational definitions, efficacy in terms of burning sensation VAS score, greater inter Incisal distance & tongue Protrusion will be compared between Curcumin and Intralesional steroid groups.
Data Collection Tools:
All Study variables will be assessed by single person at Month 1, Month 2 and Month 3 post clinical trial. Clinical parameters will be assessed through proforma designed in English as well as in Local language.
Data Analysis Procedure:
Statistical Package for Social Sciences (SPSS) version 27 will be used for data entry & analysis. The quantitative variables such as age, burning sensation VAS score, mouth opening & tongue Protrusion, will reported using mean ± standard deviation. The quantitative variable such as gender will be reported using percent. The baseline profile between groups will be compared using student t-test. The improvement within the group by the end of 1st, 2nd & 3rd month will be tabulated & analyzed. The clinical improvement of a particular regimen (within the same group) before & after treatment will be analyzed using paired t-test. The improvement observed serially within the same group will be evaluated using repeated measures ANOVA. Comparisons between the two groups will be done using unpaired t-test.
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Hafiza Sara Adrees, BDS
- Phone Number: +92 307 3002818
- Email: saramidrees113@gmail.com
Study Contact Backup
- Name: Hafiz Aamer Iqbal, BDS FCPS OMFS
- Phone Number: +92 333 4955789
- Email: haafiz.amer.iqbal@gmail.com
Study Locations
-
-
Punjab
-
Lahore, Punjab, Pakistan, 5400
- Services Institute of Medical Sciences
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients diagnosed with Oral submucous fibrosis in accordance with operational definition.
- Male & Female
Exclusion Criteria:
- Patient unable to quit the habit of gutkha, tobacco & betel nut chewing
- Patient With uncontrolled diabetes
- Patient with chronic kidney disease
- Pregnant female
- Patient with untreated malignancy/taking immunosuppressant drugs
- Patient with H/O ORAL SUBMUCOUS FIBROSIS in last months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Active Comparator: Group A
The Group A will undergo curcumin treatment for oral submucous Fibrosis.
In Group A curcumin capsule (500 mg) will be given two per day.
Patient will receive 1000 mg curcumin per day and will be assessed month on month basis for three months.
|
Curcumin Capsule will be given two per day for three months.
Patient Recovery progress will be monitored month on month basis for consecutive three month.
|
|
Experimental: Group B
The Group B will undergo Intralesional Steroids treatment in oral submucous fibrosis.
In Group B Intralesional Steroid Injection will be administered weekly and assessed on monthly basis for three months.
|
Intralesional Steroid Injection (1cc), one per week, will be administered in the fibrous bands wherever formed in the oral cavity.
Patient recovery progress will be monitored on monthly basis for three months.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mean of Mouth Opening
Time Frame: Month 1, Month 2, Month 3
|
Mouth opening is progressively restricted due to fibroses and stiffness of oral tissue.
It will be measured in mm.
Patient will be asked to open mouth as wide as he/she can & with the help of metal scale & divider (Vernier caliper) between maxillary incisor & mandibular incisor.
|
Month 1, Month 2, Month 3
|
|
Mean of Burning Sensation
Time Frame: Monthl 1, Month 2, Month 3
|
A burning sensation in oral submucous fibrosis is often due to tissue changes, dryness, nutritional deficiencies, or secondary infections affecting the oral mucosa.
Patient will be asked for burning sensation & based on severity numerical score given by VAS (Visual Analog Scale) 0-100.
|
Monthl 1, Month 2, Month 3
|
|
Mean of Tongue Protrusion
Time Frame: Month 1, Month 2, Month 3
|
Tongue Protrusion in oral submucous fibrosis refers to the difficulty or inability to fully move the tongue out of the mouth.
It will be assessed from normal mesio-incisal angel of maxillary central incisor to the tip of tongue when maximally extended with wide mouth open by Visual Analogue Scale (VAS) 0-100.
|
Month 1, Month 2, Month 3
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Nagpal M, Sood S. Role of curcumin in systemic and oral health: An overview. J Nat Sci Biol Med. 2013 Jan;4(1):3-7. doi: 10.4103/0976-9668.107253.
- Kerr AR, Warnakulasuriya S, Mighell AJ, Dietrich T, Nasser M, Rimal J, Jalil A, Bornstein MM, Nagao T, Fortune F, Hazarey VH, Reichart PA, Silverman S, Johnson NW. A systematic review of medical interventions for oral submucous fibrosis and future research opportunities. Oral Dis. 2011 Apr;17 Suppl 1:42-57. doi: 10.1111/j.1601-0825.2011.01791.x.
- Roques C, Teot L. The use of corticosteroids to treat keloids: a review. Int J Low Extrem Wounds. 2008 Sep;7(3):137-45. doi: 10.1177/1534734608320786. Epub 2008 Jul 8.
- Ramesh, D.N.S.V., Saba N. lycopene and combination of lycopene with multivitamins in the treatment of oral submucous fibrosis patients - A comparative study. Int. J Curr Res. 2017;9:53177-82.
- Piyush P, Mahajan A, Singh K, Ghosh S, Gupta S. Comparison of therapeutic response of lycopene and curcumin in oral submucous fibrosis: A randomized controlled trial. Oral Dis. 2019 Jan;25(1):73-79. doi: 10.1111/odi.12947. Epub 2018 Aug 22.
- Bohra A, Maheswari TNU, Harsh A, Garg A. Black Turmeric and Aloe Vera in the Management of Oral Submucous Fibrosis: A Prospective Clinical Study. Asian Pac J Cancer Prev. 2021 Dec 1;22(12):3941-3947. doi: 10.31557/APJCP.2021.22.12.3941.
- Yadav M, Aravinda K, Saxena VS, Srinivas K, Ratnakar P, Gupta J, Sachdev AS, Shivhare P. Comparison of curcumin with intralesional steroid injections in Oral Submucous Fibrosis - A randomized, open-label interventional study. J Oral Biol Craniofac Res. 2014 Sep-Dec;4(3):169-73. doi: 10.1016/j.jobcr.2014.11.003. Epub 2014 Nov 20.
- Zhang SS, Gong ZJ, Li WH, Wang X, Ling TY. Antifibrotic effect of curcumin in TGF-beta 1-induced myofibroblasts from human oral mucosa. Asian Pac J Cancer Prev. 2012;13(1):289-94. doi: 10.7314/apjcp.2012.13.1.289.
- Aziz SR. Coming to America: betel nut and oral submucous fibrosis. J Am Dent Assoc. 2010 Apr;141(4):423-8. doi: 10.14219/jada.archive.2010.0194.
- Nigam NK, Aravinda K, Dhillon M, Gupta S, Reddy S, Srinivas Raju M. Prevalence of oral submucous fibrosis among habitual gutkha and areca nut chewers in Moradabad district. J Oral Biol Craniofac Res. 2014 Jan-Apr;4(1):8-13. doi: 10.1016/j.jobcr.2013.10.005. Epub 2013 Nov 20.
- Rajendran R, Deepthi K, Nooh N, Anil S. alpha4beta1 integrin-dependent cell sorting dictates T-cell recruitment in oral submucous fibrosis. J Oral Maxillofac Pathol. 2011 Sep;15(3):272-7. doi: 10.4103/0973-029X.86678.
- Pindborg JJ, Sirsat SM. Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol. 1966 Dec;22(6):764-79. doi: 10.1016/0030-4220(66)90367-7. No abstract available.
- Hazarey VK, Erlewad DM, Mundhe KA, Ughade SN. Oral submucous fibrosis: study of 1000 cases from central India. J Oral Pathol Med. 2007 Jan;36(1):12-7. doi: 10.1111/j.1600-0714.2006.00485.x.
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mouth Diseases
- Stomatognathic Diseases
- Pathologic Processes
- Fibrosis
- Oral Submucous Fibrosis
- Antineoplastic Agents
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Inflammatory Agents
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Antirheumatic Agents
- Sensory System Agents
- Analgesics, Non-Narcotic
- Analgesics
- Anti-Inflammatory Agents, Non-Steroidal
- Curcumin
Other Study ID Numbers
- U111-1315-4100
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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