Topical immunomodulators for management of oral mucosal conditions, a systematic review; part I: calcineurin inhibitors.

IMPORTANCE OF THE FIELD: Topical immunomodulators have been used for the management of oral mucosal diseases. Topical immunomodulating preparations may have utility in local management of oral disease which is resistant to topical steroids and oral findings of an immunologic-mediated systemic disease with primary or persisting, oral mucosal involvement. AREAS COVERED IN THIS REVIEW: This paper is the first part of a systematic review of topical immunomodulators for the management of various oral indications focused on calcineurin inhibitors. The literature search revealed that data are available for cyclosporine, tacrolimus and pimecrolimus. In addition to the review of scientific evidence, this paper presents the potential market, the mechanism of action, the competitive environment and future development options. WHAT THE READER WILL GAIN: The reader will find weighted conclusions for the topical use of the calcineurin inhibitors in the management of oral diseases. TAKE HOME MESSAGE: Topical calcineurin inhibitors may be useful as a second-line treatment in several oral diseases, particularly oral lichen planus.