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

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.