Patients with lichen planus show improvement with baracitinib

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.”