Patients with lichen planus show improvement with baracitinib
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Key takeaways:
- All patients treated with baracitinib for lichen planus had a response at week 12.
- After 1 week of treatment, 37.5% of patients had a physician global assessment response of clear or almost clear.
NEW ORLEANS — A first-in-human study found patients with lichen planus treated with the Janus kinase inhibitor baracitinib achieved almost total improvement, according to a presenter at the American Academy of Dermatology Annual Meeting.
“Cutaneous [lichen planus (LP)] is an inflammatory skin disease that is characterized by the five P’s – purple, polygonal, pruritic, papules and plaques,” Angelina Hwang, BS, a fourth-year medical student at Mayo Clinic Arizona and one of the study investigators, said during her presentation. “There is a need for new therapies with a more desirable long-term side effect profile or for use in refractory disease, but at this point and time no disease-specific medications for LP exist.”
Researchers conducted an open-label, single-arm trial in 12 patients with LP who were treated with baracitinib twice daily for 16 weeks.
Prior research concluded that interferon gamma is a key mediator in LP’s pathogenesis, leading to the hypothesis that a Janus kinase inhibitor would be a promising treatment option, according to Hwang.
After 1 week of treatment, 37.5% of patients were responsive to baracitinib, with 100% of patients showing a PGA response of clear or almost clear at week 12.
At week 16, 90.9% of patients were responsive, which increased to 100% at week 20 after 4 weeks off therapy.
Improvements in all secondary endpoints, including BSA, total body lesion count and pruritus score, were also observed.
A total of 12 adverse events were recorded, with one — low neutrophil count — determined to be related to the study medication.
“Targeted therapy with baracitinib in LP led to a rapid and sustained response in cutaneous LP,” Hwang said. “Based on the promising results of this open-label, single-arm trial, future randomized controlled trials of baracitinib are warranted.”