Treatment of lichen planopilaris with baricitinib: A retrospective study

Article summary by Wonder Edem-Ineama | MD Candidate 2024 | University of California, Riverside School of Medicine.

Lichen Planopilaris and Frontal Fibrosing Alopecia are inflammatory cicatricial alopecia disorders. A retrospective study was completed on whether Baricitinib, an inhibitor of the JAK-1/2 signaling pathway, can alleviate the symptoms of classical LPP and FFA. The study consisted of 12 patients total with recalcitrant LPP, 7 with classical LPP and 5 with FFA. To monitor disease activity, the Lichen Planopilaris Activity index (LPPAI) was used, ranging from 0 to 10, with 10 being the most severe. This study found that the average (LPPAI) was 5.8, and after initial treatment the LPPAI decreased by 1.2 (20.2%) and after 6 months it decreased by 1.3 (23.1%). Alternatively, four patients, 2 with classical LPP and 2 with FFA, did not improve with Baricitinib and their condition progressed. Three patients with recalcitrant LPP were previously treated with Tofacitinib, a JAK-1/3 inhibitor, in the past without improvement. Those same 3 patients had improvement with Baricitinib, which means that this medication may also be used for treatment recalcitrant LPP. All the patients were given concurrent treatment in addition to Baricitinib, therefore limiting evidence that Baricitinib may be effective as treatment individually. Adverse events recorded were transaminitis, hypercholesterolemia, neutropenia, and fatigue. In order to support conclusive evidence about Baricitinib, larger prospective studies need to be completed. Overall, this data illustrates potential for Baricitinib becoming a medication included in the resolution of recalcitrant and classical Lichen Planopilaris and Frontal Fibrosing Alopecia.

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Reference: Treatment of lichen planopilaris with baricitinib: A retrospective study. Anthony Moussa, MBBS, MS, Bevin Bhoyrul, MBBS, MRCP, Leila Asfour, MBChB, BSc, MRCP, Ahmed Kazmi, MBChB, MRCP, Samantha Eisman, MBChB, MRCP, and Rodney Daniel Sinclair, MBBS, MD. From Sinclair Dermatology, East Melbourne, Victoria, Australia; and University of Melbourne, Melbourne, Victoria, Australia.