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Oral Baricitinib in the Treatment of Cutaneous Lichen Planus.

Authors :
Hwang A
Kechter J
Do T
Hughes A
Zhang N
Li X
Wasikowski R
Brumfiel C
Patel M
Boudreaux B
Bhullar P
Nassir S
Yousif M
DiCaudo DJ
Fox J
Gharaee-Kermani M
Xing X
Zunich S
Branch E
Kahlenberg JM
Billi AC
Plazyo O
Tsoi LC
Pittelkow MR
Gudjonsson JE
Mangold AR
Source :
MedRxiv : the preprint server for health sciences [medRxiv] 2024 Jan 11. Date of Electronic Publication: 2024 Jan 11.
Publication Year :
2024

Abstract

Background: Cutaneous lichen planus (LP) is a recalcitrant, difficult-to-treat, inflammatory skin disease characterized by pruritic, flat-topped, violaceous papules on the skin. Baricitinib is an oral Janus kinase (JAK) 1/2 inhibitor that interrupts the signaling pathway of interferon (IFN)-γ, a cytokine implicated in the pathogenesis of LP.<br />Methods: In this phase II trial, twelve patients with cutaneous LP received baricitinib 2 mg daily for 16 weeks, accompanied by in-depth spatial, single-cell, and bulk transcriptomic profiling of pre-and post-treatment samples.<br />Results: An early and sustained clinical response was seen with 83.3% of patients responsive at week 16. Our molecular data identified a unique, oligoclonal IFN-γ, CD8+, CXCL13+ cytotoxic T-cell population in LP skin and demonstrate a rapid decrease in interferon signature within 2 weeks of treatment, most prominent in the basal layer of the epidermis.<br />Conclusion: This study demonstrates the efficacy and molecular mechanisms of JAK inhibition in LP. Trial Registration Number : NCT05188521.

Details

Language :
English
Database :
MEDLINE
Journal :
MedRxiv : the preprint server for health sciences
Publication Type :
Academic Journal
Accession number :
38260663
Full Text :
https://doi.org/10.1101/2024.01.09.24300946