Deucravacitinib in the treatment of lichen planopilaris: 28-week analysis of patient-reported outcome metrics

Summary: Abstract Body: Lichen planopilaris (LPP) is a form of lymphocyte-mediated scarring alopecia that presents on the scalp as discrete patches with characteristic perifollicular erythema and scale. The pathogenesis of LPPs involves the JAK/STAT pathway. Deucravacitinib is an oral selective inhibitor of tyrosine kinase 2 (TYK2), a member of the Janus kinase (JAK) family. This open-label, single-arm phase II clinical trial (NCT-06091956) included adult patients with biopsy-proven, active LPP. Patients were treated with deucravacitinib 6 mg twice daily for 24 weeks with 4-week safety follow up. Patient-reported outcome measures (PROMs) were assessed by Dermatology Life Quality Index (DQLI), Visual Analogue Score (VAS), Numerical Rating Scale (NRS), and Skindex-16. Patients (N=10) had a mean (SD) age of 61.4 (11.7); 70% were female and 100% were White. Median (range) disease duration was 6.4 (1.67-15) years, with a mean (SD) of 1.7 (1.3) prior systemic treatments. Baseline mean (SD) DQLI, VAS, NRS, and Skindex-16 scores were 3.8 (2.0), 3.4 (2.4), 4.2 (2.4), and 36.3 (18.6) respectively. Mean (SD) NRS score decreased to 2.3 (1.9) at Week 24. Patient-reported 24-hour itch improved from 60% (n=6) reporting mild/no itch at baseline to 100% (n=9) and 77.8% (n=7) at Weeks 16 and 24, respectively. There was significant improvement in mean Skindex-16 score (-22.5, p=0.020) at Week 24 compared to baseline. Deucravacitinib was well tolerated, with no serious treatment-emergent adverse events (TEAEs), or TEAEs leading to discontinuation. This was the first clinical trial to investigate a selective TYK2 inhibitor in LPP. Patients demonstrated improvement across multiple PROMs, including improvements in itch and pain metrics, and significant improvement in Skindex-16 scores at Week 24. Alyssa L. Stockard⁴, Zachary Leibovit-Reiben⁴, Nan Zhang¹, Shams Nassir⁴, Miranda Yousif⁴, Samantha Zunich⁴, Alysia Hughes⁴, Johann E. Gudjonsson², Jason Sluzevich³, Mark Pittelkow⁴, Aaron R. Mangold⁴ 1. Quantitative Health Sciences, Mayo Clinic Arizona, Scottsdale, AZ, United States. 2. Dermatology, University of Michigan, Ann Arbor, MI, United States. 3. Dermatology, Mayo Clinic in Florida, Jacksonville, FL, United States. 4. Dermatology, Mayo Clinic Arizona, Scottsdale, AZ, United States. Clinical Research: Interventional Research