Topical ruxolitinib as a treatment for cutaneous lichen planus: A phase II study

By Samar Mahmoud, MS

Published February 12, 2022

Key Takeaways

This prospective phase II study found that topical ruxolitinib was effective in the treatment of cutaneous lichen planus (LP).
LP was confirmed to be an interferon-driven disease by transcriptomic analysis.
Investigators found that the downregulation of interferon-stimulated genes (ISGs) correlated with disease response.

Recent studies have shown that inflammation in LP is mediated by interferon-gamma.

Why This Study Matters

Based on previous work implicating interferon-gamma in the pathogenesis of LP, it was hypothesized that a Janus kinase 1/2 inhibitor (JAK1/2), which blocks signal transduction of interferon-gamma, may be beneficial as a treatment for LP. To test this, this study evaluated the efficacy of topical ruxolitinib use in cutaneous LP patients.

Study Design

This study included 12 patients with cutaneous LP. Participants applied topical ruxolitinib twice every day for 8 weeks. The primary endpoints of the study were the change in total lesion count and the modified Composite Assessment of Index Lesion Severity (mCAILS) score in treated and untreated control lesions at week 4.

Results and Conclusions

In patients treated with ruxolitinib, the total lesion count declined by a median of 50 lesions. Similarly, the mCAILS scores decreased by an average difference of 7.6 between the index treated and control lesions. Investigators found an enrichment of type I and II interferon pathways in LP. Transcriptomic analysis showed that the downregulation of ISGs correlated with disease response.

Related Research

Using a drug prediction algorithm, this study identified JAK inhibitors as a promising treatment for patients with LP (Source).
Targeting of Th17/Tc17 cells led to a significant improvement in mucosal and cutaneous LP patients, suggesting IL-17 producing T cells are integral to LP disease pathogenesis (Source).

Original Source

Brumfiel CM, Patel MH, Severson KJ, et al. Ruxolitinib cream in the treatment of cutaneous lichen planus: A prospective, open-label study. Journal of Investigative Dermatology. Published online February 2022:S0022202X22000835.