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Phase 2 N=111 Randomized Quadruple-blind Treatment

PoC Study to Evaluate the Efficacy and Safety of Secukinumab 300 mg in Patients With Lichen Planus

Lichen Planus: Cutaneous Lichen Planus, Mucosal Lichen Planus and Lichen Planopilaris

Enrolled (actual)
111
Serious AEs
3.3%
Results posted
Aug 2023
Primary outcome: Primary: Response Rate of Investigator Global Assessment (IGA) Score of 2 or Lower at Week 16 for CLP, MLP and LPP — 44.0; 58.2; 37.5; 23.1 percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
secukinumab 300 mg Q4W (Drug); secukinumab 300 mg Q2W (Drug); Placebo (Other)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Novartis Pharmaceuticals
Primary completion
Nov 2021

Outcome Measures

OutcomeResultp-value
PRIMARY
Response Rate of Investigator Global Assessment (IGA) Score of 2 or Lower at Week 16 for CLP, MLP and LPP
44.0; 58.2; 37.5; 23.1; 37.6; 30.9
SECONDARY
Number (%) of Subjects With IGA ≤ 2 Response, IGA ≥2 Points Improvement Response, and IGA 0 or 1 Response by Visit - CLP Cohort (BOCF)- Entire Treatment Period (FAS)
5; 1; 2; 0; 2; 0
SECONDARY
Number (%) of Subjects With IGA ≤ 2 Response, IGA ≥2 Points Improvement Response, and IGA 0 or 1 Response by Visit - MLP Cohort (BOCF)- Entire Treatment Period (FAS)
5; 3; 1; 1; 1; 1
SECONDARY
Number (%) of Subjects With IGA ≤ 2 Response, IGA ≥2 Points Improvement Response, and IGA 0 or 1 Response by Visit - LPP Cohort (BOCF)- Entire Treatment Period (FAS)
4; 1; 1; 0; 1; 0
SECONDARY
Number (%) of Subjects in Each Category in Physician´s Assessment of Surface Area of Disease (PSAD) - CLP (BOCF) - Entire Treatment Period (FAS)
0; 0; 3; 0; 6; 0
SECONDARY
Number (%) of Subjects With Dermatology Life Quality Index Response Scores of 0 to 1 up to Week 32 - CLP Cohort - Entire Treatment Period (FAS)
0; 0; 2; 0; 2; 0
SECONDARY
Number (%) of Subjects With Dermatology Life Quality Index Response Scores of 0 to 1 up to Week 32 - MLP Cohort - Entire Treatment Period (FAS)
0; 0; 2; 1; 4; 1
SECONDARY
Number (%) of Subjects With Dermatology Life Quality Index Response Scores of 0 to 1 up to Week 32 - LPP Cohort - Entire Treatment Period (FAS)
0; 0; 3; 1; 3; 1
SECONDARY
Summary of Baseline Score and Change From Baseline for Patient Assessment of Itch Using Numeric Rating Scale (NRS) by Question - CLP Cohort (BOCF) (FAS)
5.1; 5.7; 5.8; -0.8; -2.3; -2.0
SECONDARY
Summary of Baseline Score and Change From Baseline for Patient Assessment of Itch Using Numeric Rating Scale (NRS) by Question - MLP Cohort (BOCF) (FAS)
2.5; 3.8; 4.3; 0.3; -0.2; -0.3
SECONDARY
Summary of Baseline Score and Change From Baseline for Patient Assessment of Itch Using Numeric Rating Scale (NRS) by Question - LPP Cohort (BOCF) (FAS)
4.5; 3.8; 3.8; -0.5; -1.1; -1.1
SECONDARY
Summary of Baseline Score and Change From Baseline for Patient Assessment of Pain Using Numeric Rating Scale (NRS) by Question - CLP Cohort (BOCF) (FAS)
1.09; 3.4; 3.5; 0.2; -0.8; -0.8
SECONDARY
Summary of Baseline Score and Change From Baseline for Patient Assessment of Pain Using Numeric Rating Scale (NRS) by Question -MLP Cohort (BOCF) (FAS)
5.1; 5.9; 6.3; -0.5; -0.1; 0.0
SECONDARY
Summary of Baseline Score and Change From Baseline for Patient Assessment of Pain Using Numeric Rating Scale (NRS) by Question - LPP Cohort (BOCF) (FAS)
2.5; 2.0; 2.0; 0.3; -0.5; -0.5
SECONDARY
Summary of Baseline Score and Change From Baseline in Reticular Erythematous Ulcerative Score (REU) - MLP Cohort - (BOCF) - Entire Treatment Period
21.31; 25.29; 26.95; -4.83; -5.79; -4.10
SECONDARY
Summary of Baseline Score and Change From Baseline in Oral Lichen Planus Symptom Severity Measure (OLPSSM) - MLP Cohort - (BOCF) - Entire Treatment Period
11.0; 13.4; 13.9; -1.0; 0.8; -0.4
SECONDARY
Summary of Baseline Score and Change From Baseline for Lichen Planopilaris Activity Index (LPPAI)- LPP Cohort (BOCF) (FAS)
5.92; 5.95; 5.95; -1.44; -2.24; -2.24
SECONDARY
Summary of Baseline Score and Change From Baseline for Scalpdex - LPP Cohort (BOCF) (FAS)
55.75; 54.01; 54.01; 1.86; -6.94; -6.94

Summary

The primary purpose of the proof of concept study is to elucidate the efficacy of secukinumab in the treatment of adult patients with biopsy-proven lichen planus not adequately controlled by topical therapies, and to assess the safety and tolerability over 32 weeks.

Eligibility Criteria

Inclusion Criteria

  • Written informed consent must be obtained before any assessment is performed.
  • Female and male patients ≥ 18 years of age.
  • Subjects must have biopsy-confirmed forms of cutaneous lichen planus (CLP), mucosal lichen planus (MLP), or active lichen planopilaris (LPP) eligible for systemic therapy based on the following criteria:
  • rated IGA of ≥ 3 (moderate or severe) AND
  • inadequate response to topical corticosteroids of high-ultrahigh potency in the opinion of the investigator.
  • If using any of the allowed topical treatments on the affected areas, the dose and application frequency should remain stable for 2 weeks prior to randomization and until Week 16.

Exclusion Criteria

  • Clinical history suspicious for lichenoid drug eruption.
  • Lichen planus pigmentosus.
  • Clinical picture or history suspicious of paraneoplastic mucosal lichen planus.
  • Subjects whose lichen planus is a predominantly bullous variant.
  • Mucosal LP of the oral cavity or gastrointestinal involvement requiring the patient to use parenteral nutrition or feeding tube.
  • Clinical picture of scarring alopecia without active inflammation.
  • Clinical picture of burnt-out cicatricial alopecia (alopecia of Brocque).
  • Patients diagnosed with frontal fibrosing alopecia (FFA) without active patches of LPP
  • Clinical picture of LPP in patients who have already failed 3 or more systemic immunosuppressive or immunomodulatory agents (e.g. systemic steroids, hydroxychloroquine, cyclosporine, methotrexate and mycophenolate mofetil).
  • Currently enrolled in any other clinical trial involving any investigational agent or device.
  • Previous exposure to any other biologic drug directly targeting IL-17A or IL-17RA (e.g. secukinumab, ixekizumab or brodalumab) or IL-23/p19 (e.g. tildrakizumab, guselkumab, risankizumab).
  • Diagnosis of active infectious diseases of the skin, scalp or mucosa (for example bacterial, viral or fungal infections of the mouth) that may interfere with the assessment of the study disease or require treatment with prohibited medications.
  • Diagnosis of active inflammatory diseases of the skin, scalp or mucosa other than lichen planus that may interfere with the assessment of the study disease or require treatment with prohibited medications.
  • Presence of any other skin condition that may affect the evaluations of the study disease.
  • Underlying conditions (including, but not limited to metabolic, hematologic, renal, hepatic, pulmonary, neurologic, endocrine, cardiac, infectious or gastrointestinal) and/or presence of laboratory abnormalities which in the opinion of the investigator significantly immunocompromises the subject and/or places the subject at unacceptable risk for receiving an immunomodulatory therapy.
  • Current, severe, progressive or uncontrolled diseases that render the patient unsuitable for the trial, including any medical or psychiatric condition that, in the Investigator's opinion, would preclude the participant from adhering to the protocol or completing the study per protocol.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04300296). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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