Treatment outcomes of Janus kinase inhibitors in oral lichen planus; a systematic review of cases reported globally

Abstract

Objective: This study aims to review studies on Janus kinase inhibitors (JAKi) in order to determine their efficacy and safety in the treatment of erosive oral lichen planus (OLP).

Design and data sources: A systematic review was conducted through PubMed/Medline, Google Scholar, and ScienceDirect databases using PRISMA guidelines. Study quality assessment was performed using Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and Case Series.

Eligibility criteria: Case reports, and case series published between January 2020 - November 2025 with no language or geographic restrictions.

Data extraction and synthesis: Retrieved data included patient demographics and disease outcomes. Descriptive statistical analyses and qualitative data synthesis were employed.

Results: A total of 15 case reports / series described 45 patients. Patients were mostly females (94.7%), with an age range of 30-89 years (weighted mean=55.31 years). A total of seven JAKi have been described for the management of OLP, of which tofacitinib and upadacitinib were the most commonly prescribed. A total of 18 patients (40.0%) showed complete resolution with treatment durations extending from 3 months-6 years. Seventeen patients (37.7%) required adjunctive corticosteroids, or other immunosuppressive treatment. Reported adverse effects were mostly mild in the form of cutaneous, gastrointestinal and liver disturbances.

Conclusions: To date, seven different JAKi have been reported to be effective in the treatment of erosive OLP. Current evidence suggests that JAKi may represent a promising and generally well-tolerated therapeutic option for erosive OLP patients, particularly those with refractory disease. Nevertheless, further research is warranted to establish their long-term efficacy and safety. Future studies should focus on optimizing treatment duration, evaluating the role of combination immunomodulatory therapies, and identifying patient-related factors that may influence treatment outcomes.