JAK Inhibitors in the Treatment of Lichen Planopilaris

Skin Appendage Disord. 2024 Feb;10(1):10-17. doi: 10.1159/000534631. Epub 2023 Nov 9.

Abstract

Background: Lichen planopilaris (LPP) is an autoimmune disorder leading to lymphocytic cicatricial alopecia. Different agents such as hydroxychloroquine, methotrexate, cyclosporine, and mycophenolate mofetil have been tried to control hair loss with limited efficacy. JAK inhibitors are immune-modulating drugs which interfere with the JAK-STAT signaling pathway in lymphocytes and are used in treatment of inflammatory conditions such as rheumatoid arthritis and alopecia areata.

Summary: Our aim was to determine effectiveness of JAK inhibitors in LPP and its clinical variant, frontal fibrosing alopecia. A literature search was conducted using PubMed, Google Scholar, and Cochrane databases. A total of 7 articles describing 35 patients were found. Although data on treatment are limited to retrospective studies and case reports, JAK inhibitors can be considered a new therapeutic option, especially in recalcitrant cases. Large prospective studies and randomized control trials are needed to provide further evidence supporting efficacy.

Key messages: Besides the fact that data on the treatment of LPP and FFA with JAK inhibitors are limited to retrospective studies and case reports, but JAK inhibitors can be considered as a new therapeutic option especially in recalcitrant cases.

Keywords: Baricitinib; Cicatricial alopecia; Frontal fibrosing alopecia; JAK inhibitors; Lichen planopilaris; Scarring alopecia; Tofacitinb.

Plain language summary

Lichen planopilaris (LPP) is a condition where the immune system attacks hair follicles, causing permanent hair loss. Doctors have tried different medications to control the hair loss, but with limited success. JAK inhibitors are drugs that can affect the immune system and are used to treat conditions like rheumatoid arthritis and alopecia areata. We wanted to find out if JAK inhibitors could help with LPP. We looked at research articles in medical databases and found 7 articles that talked about 35 patients. Although the information on treatment is limited to studies that looked back at past cases and individual reports, JAK inhibitors could be a new option for treatment, especially when other treatments have not worked. We need more studies with larger groups of people to get more evidence on how well JAK inhibitors work for LPP.

Publication types

  • Review

Grants and funding

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.