In more than 90% of patients with lichen planus (LP), response to treatment was observed for baricitinib in a first-in-human trial. A phase 2 study led by principal investigator Aaron R. Mangold, MD examined the JAK1/2 inhibitor baricitinib as LP therapy, based on the reasoning that it suppresses the production of interferon-γ, a critical component in the pathogenesis of LP.

Dr. Mangold presented the results of the study at the 2023 American Academy of Dermatology annual meeting.

“There is a great unmet need for disease-specific medication in LP, as to date, treatment options only include drugs like corticosteroids, topical calcineurin inhibitors, and phototherapy,” Dr. Mangold said.

Angelina S. Hwang co-presented the interim analysis of the open-label trial, which included data on 12 patients with LP; among them, 41.7% had hypertrophic disease.1 The mean age of the participants was 63.6, 91.7% were women, and all participants but one had failed previous treatments.

At week 16, the primary endpoint of a Physician Global Assessment (PGA) response, defined as reaching a PGA score of 0–3, was met by 90.9%. At this point, 45.5% presented a PGA of 0, standing for clear skin. The response rate was 100% at weeks 12 and 20.  Moreover, significant improvements were also found in all secondary endpoints that included BSA, pruritus, and Skindex-16, which measured the effects of skin disease on QOL. Of 12 reported adverse events, only one was deemed treatment-related, but not serious.

“These promising, initial results on baricitinib at a dosing of 2 mg for LP could justify a further evaluation of the agent in randomized-controlled trials,” the study authors wrote.


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