Ruxolitinib cream a promising option for lichen planus

Treatment with ruxolitinib cream helps reduce lesion and itch in patients with lichen planus, as shown in a phase II trial.

The trial included 64 adult patients (median age 57 years, 72 percent female, 63 percent White) with predominantly cutaneous lichen planus, an Investigator’s Global Assessment (IGA) score of 3 or 4, an Itch Numerical Rating Scale score of 4 or greater, and an affected body surface area of ≤20 percent.

The patients were randomly assigned to treatment with ruxolitinib 1.5% or vehicle cream, applied twice daily for 16 weeks. Eligible patients applied ruxolitinib cream twice daily as needed in a 16-week, open-label extension.

At week 16, significantly more patients in the ruxolitinib group vs the vehicle group achieved the primary endpoint of IGA treatment success (50 percent vs 21.9 percent; difference, 29.4 percent, 95 percent confidence interval [CI], 7.6–51.3; p=0.01). Treatment success was defined as an IGA score of 0 or 1 (clear/almost clear skin), with a ≥2-grade improvement from baseline.

The proportion of patients who achieved at least a 4-point improvement from baseline in Itch Numerical Rating Scale score at week 16 was also significantly greater in the ruxolitinib group than in the vehicle group (48.4 percent vs 16.1 percent; response rate difference, 33.5 percent, 95 percent CI, 12.2–54.9; p=0.004).

There were no serious treatment-emergent adverse events or discontinuations due to an adverse event documented in the ruxolitinib group.