The Use of Janus Kinase Inhibitors for Lichen Planus: An Evidence-Based Review

J Cutan Med Surg. 2023 May-Jun;27(3):271-276. doi: 10.1177/12034754231156100. Epub 2023 Feb 23.

Abstract

Background: Lichen Planus (LP) is a dermatological disorder characterized by violaceous papules that affect the cutaneous region, nails, scalp, and mucous membranes. Current molecular and clinical studies point to the Janus Kinase-signal transducer and activator of transcription (JAK-STAT) pathway as a potential effector of LP pathology.

Objective: This systematic review summarizes the current reported literature outcomes for patients receiving JAK inhibitors to treat LP.

Methods: MEDLINE and Embase were searched on 16 October, 2022, and 15 original articles were included, with 56 LP patients.

Results: (mean age: 54.5 years, range: 26-81 years, male: 26.8%). The treatment outcomes were included for the following JAK inhibitors: tofacitinib (n = 30), baricitinib (n = 16), ruxolitinib (n = 12), and upadacitinib (n = 2). Patient outcomes were classified into complete resolution, partial resolution, and no resolution. Patients achieving complete resolution represented 25% (n = 4/16) in the baricitinib group, 10% (n = 3/30) in the tofacitinib group, 16.7% (n = 2/12) in the ruxolitinib group, and 100% (2/2) in the upadacitinib group. Partial resolution patients represented 31.3% (n = 5/16) of baricitinib patients, 60% (n = 18/30) of tofacitinib patients, and 83% (n = 10/12) of ruxolitinib patients. 43.8% (n = 7/16) of baricitinib patients and 10% (n = 9/30) of tofacitinib patients had no resolution of lesions.

Conclusion: This review also highlights the significance of utilizing a uniform outcome measure for LP, as it aids in reporting more generalizable results, reduces reporting bias, and ultimately lead to improved clinical outcomes for LP patients.

Keywords: JAK inhibitor; evidence-based; lichen planus; systematic review; systemic; therapeutics.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Humans
  • Janus Kinase Inhibitors* / therapeutic use
  • Lichen Planus* / drug therapy
  • Male
  • Middle Aged
  • Pyrazoles

Substances

  • ruxolitinib
  • Janus Kinase Inhibitors
  • baricitinib
  • Pyrazoles