Neda Cramer, Daniel Kromer, Julia M. Bootsveld, Sascha Gerdes, Petra Staubach-Renz, Katharina Assaf, Dagmar Wilsmann-Theis, Claudia Günther, Christian Kromer, Rotraut Mössner
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Drug survival from systemic therapies was assessed by Kaplan–Meier analysis and multivariate regression.</p>\n <p><b>Results:</b> Overall, 281 patients with a total of 407 treatment courses were identified. The overall median drug survival was 5.0 months (conventional drugs: 5.0 months vs. novel drugs [biologicals and Janus kinase inhibitors]: 17.0 months, <i>p</i> = 0.029). Among conventional drugs, median drug survival was numerically the highest for methotrexate (13.0 months), followed by mycophenolate mofetil (12.0 months); hydroxychloroquine (9.0 months); acitretin and cyclosporine (6.0 months each); azathioprine, dapsone, and other retinoids (5.0 months each); and finally glucocorticoids (2.0 months). Among novel drugs, median drug survival was numerically the highest in TNF-α blockers and IL-17 antagonists (median: 21.0 and 17.0 months, respectively), while median drug survival for Janus kinase inhibitors has not yet been reached. Altogether, the outcomes were documented in 68.6% of cases, with excellent (33.5%), partial (34.5%) or nonresponse (32.0%) in one-third of cases each. The group of novel therapies comprising biologicals and Janus kinase inhibitors was significantly more effective than the group of conventional drugs (excellent response: 66.7%, 8/12 vs. 32.1%, 83/258; <i>P</i> = 0.013, <i>χ</i><sup>2</sup>-test).</p>\n <p><b>Conclusions:</b> In addition to glucocorticoids, cyclosporine, mycophenolate mofetil, and methotrexate (plus hydroxychloroquine), biologicals and Janus kinase inhibitors in particular seem to be therapeutic options for the treatment of mucosal LP, which is worth investigating further.</p>\n </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2025 1","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/8752339","citationCount":"0","resultStr":"{\"title\":\"Drug Survival in the Treatment of Mucosal Lichen Planus: A Retrospective Multicenter Study\",\"authors\":\"Neda Cramer, Daniel Kromer, Julia M. 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引用次数: 0
摘要
背景与目的：粘膜扁平苔藓（LP）是一种罕见的慢性炎症性皮肤病。它的治疗很困难，而且缺乏关于不同药物可持续性的比较数据。我们旨在回顾性评估患者和疾病特征，并分析在现实条件下治疗粘膜LP的药物存活率。患者和方法：我们的回顾性研究纳入了2005年1月至2022年3月期间在德国五所大学医学中心皮肤科接受系统治疗的粘膜LP患者。评估患者和疾病特征及治疗反应。通过Kaplan-Meier分析和多变量回归评估全身治疗的药物生存期。结果：共确定281例患者，共407个疗程。总体中位药物生存期为5.0个月（传统药物：5.0个月vs新药[生物制剂和Janus激酶抑制剂]:17.0个月，p = 0.029）。在常规药物中，甲氨蝶呤的中位生存期最高（13.0个月），其次是霉酚酸酯（12.0个月）；羟氯喹（9个月）；阿维a和环孢素（各6.0个月）；硫唑嘌呤、氨苯砜和其他类维生素a（各5.0个月）；最后是糖皮质激素（2.0个月）。在新药中，TNF-α阻滞剂和IL-17拮抗剂的中位生存期最高（分别为21.0个月和17.0个月），而Janus激酶抑制剂的中位生存期尚未达到。总的来说，68.6%的病例记录了结果，其中三分之一的病例表现为良好（33.5%），部分（34.5%）或无反应（32.0%）。由生物制剂和Janus激酶抑制剂组成的新疗法组的疗效显著高于常规药物组(优异疗效：66.7%,8/12 vs 32.1%, 83/258；P = 0.013, χ2-test)。结论：除了糖皮质激素、环孢素、霉酚酸酯和甲氨蝶呤（加羟氯喹）外，生物制剂和Janus激酶抑制剂似乎是治疗粘膜LP的治疗选择，值得进一步研究。
Drug Survival in the Treatment of Mucosal Lichen Planus: A Retrospective Multicenter Study
Background and Objectives: Mucosal lichen planus (LP) is a rare chronic inflammatory skin disease. Its treatment is difficult and comparative data on the sustainability of different drugs are lacking. We aimed to retrospectively assess patient and disease characteristics and analyze drug survival rates in the treatment of mucosal LP under real-world conditions.
Patients and Methods: Our retrospective study included patients with mucosal LP treated systemically in the dermatology departments of five German University Medical Centers between 01/2005 and 03/2022. Patient and disease characteristics and treatment responses were evaluated. Drug survival from systemic therapies was assessed by Kaplan–Meier analysis and multivariate regression.
Results: Overall, 281 patients with a total of 407 treatment courses were identified. The overall median drug survival was 5.0 months (conventional drugs: 5.0 months vs. novel drugs [biologicals and Janus kinase inhibitors]: 17.0 months, p = 0.029). Among conventional drugs, median drug survival was numerically the highest for methotrexate (13.0 months), followed by mycophenolate mofetil (12.0 months); hydroxychloroquine (9.0 months); acitretin and cyclosporine (6.0 months each); azathioprine, dapsone, and other retinoids (5.0 months each); and finally glucocorticoids (2.0 months). Among novel drugs, median drug survival was numerically the highest in TNF-α blockers and IL-17 antagonists (median: 21.0 and 17.0 months, respectively), while median drug survival for Janus kinase inhibitors has not yet been reached. Altogether, the outcomes were documented in 68.6% of cases, with excellent (33.5%), partial (34.5%) or nonresponse (32.0%) in one-third of cases each. The group of novel therapies comprising biologicals and Janus kinase inhibitors was significantly more effective than the group of conventional drugs (excellent response: 66.7%, 8/12 vs. 32.1%, 83/258; P = 0.013, χ2-test).
Conclusions: In addition to glucocorticoids, cyclosporine, mycophenolate mofetil, and methotrexate (plus hydroxychloroquine), biologicals and Janus kinase inhibitors in particular seem to be therapeutic options for the treatment of mucosal LP, which is worth investigating further.
期刊介绍：
Dermatologic Therapy has been created to fill an important void in the dermatologic literature: the lack of a readily available source of up-to-date information on the treatment of specific cutaneous diseases and the practical application of specific treatment modalities. Each issue of the journal consists of a series of scholarly review articles written by leaders in dermatology in which they describe, in very specific terms, how they treat particular cutaneous diseases and how they use specific therapeutic agents. The information contained in each issue is so practical and detailed that the reader should be able to directly apply various treatment approaches to daily clinical situations. Because of the specific and practical nature of this publication, Dermatologic Therapy not only serves as a readily available resource for the day-to-day treatment of patients, but also as an evolving therapeutic textbook for the treatment of dermatologic diseases.
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