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Oral Lichen PlanusPhase 4NCT07131813

Evaluation of Efficacy and Safety of add-on Tofacitinib in Patients With Oral Lichen Planus

A Phase 4 study testing Tofacitinib 5 mg BID and Triamcinolone ointment in people with Oral Lichen Planus, run by All India Institute of Medical Sciences, Bhubaneswar at 1 site in India.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Many of the patients with oral lichen planus (OLP) either fail to achieve complete remission or experience frequent relapses with conventional topical corticosteroid therapy, which is currently the mainstay of treatment. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Oral Lichen Planus
What is being tested?
Tofacitinib 5 mg BID and Triamcinolone ointment
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteIndia
Study dates
10 Oct 2025to 1 Jun 2027
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients aged ≥18 of either sex with the clinical diagnosis of oral lichen planus.
  • Patients with a PGA score of ≥3 (moderate and severe oral LP).
  • Patients who are willing to give informed written consent.

Who cannot join

  • Treatment with a systemic corticosteroid within the last 4 weeks.
  • Patients on immunosuppressive agents such as azathioprine, cyclosporine, and others within one month of recruitment.
  • Patients with a clinical history and any lesion distribution suspicious of a lichenoid drug eruption, and patients with other skin diseases.
  • Past or current history of any malignancy, including moderate to severe dysplasia of the oral mucosa on oral biopsy.
  • Severe active infection, including active tuberculosis, hepatitis B, or C infection
  • Patients with cytopenia (Hb <9g/dl, leukocyte count <4000/mm3, platelet count <100,000/mm3)
Show all 11Show fewer
  • The patient with a history of alcohol abuse.
  • Decreased liver or renal function (creatinine > 2.0mg/dl, total bilirubin > 2.5 mg/dl).
  • Severe acute infection, uncontrolled diabetes mellitus, congenital or acquired immunodeficiency, severe cardiac disease (NYHA grade IV), MI in the last four weeks, severe schizophrenia, or depression.
  • Patient with a history of hypersensitivity to topical Triamcinolone or Tofacitinib.
  • Pregnancy and lactation, women of childbearing age without effective contraception.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

India1 site, 1 recruiting
  • AIIMS, Bhubaneswar

    Bhubaneswar, Odisha, 751019

    Monalisa Jena, MD, 9438884193, pharm_monalisa@aiimsbhubaneswar.edu.in

    Ajaya Sahoo, MD

    Recruiting

Other trials in India

About this study

Official title: Evaluation of Efficacy and Safety of add-on Tofacitinib in Patients With Oral Lichen Planus: A Randomized Clinical Trial

Many of the patients with oral lichen planus (OLP) either fail to achieve complete remission or experience frequent relapses with conventional topical corticosteroid therapy, which is currently the mainstay of treatment. Long-term corticosteroid use is limited by local and systemic adverse effects, and many patients develop steroid resistance or intolerance. To overcome these limitations, combination therapy with agents having complementary mechanisms may improve therapeutic outcomes, reduce steroid requirements, and minimize associated adverse effects. Tofacitinib, a Janus kinase (JAK1/JAK3) inhibitor, modulates the JAK-STAT signaling pathway, thereby reducing inflammatory cytokine production involved in OLP pathogenesis. Preliminary case series and pilot trials have shown promising results with tofacitinib in OLP. However, to date, no randomized controlled trial has evaluated the efficacy and safety of add-on oral tofacitinib with standard topical steroid therapy in OLP. Hence, investigators considered tofacitinib to be a candidate drug for add-on therapy due to its anti-inflammatory and immunomodulatory properties. Adding tofacitinib to ongoing topical triamcinolone therapy may increase the response rate, reduce adverse drug reactions by lowering steroid dose requirements, or achieve a quicker therapeutic effect. Therefore, the present randomized controlled trial has been planned to evaluate the efficacy and safety of oral tofacitinib as an add-on therapy in patients with OLP.

Read the detailed description

Lichen planus (LP) is a chronic, mucocutaneous inflammatory disorder that manifests as violaceous, polygonal, flat-topped papules and plaques, usually affecting the skin, oral mucosa, genital mucosa, and nails. Oral Lichen Planus (OLP) is the most persistent and symptomatic of its many forms, frequently impairing basic functions like eating, speaking, and swallowing. Oral Lichen Planus is an immune-mediated condition characterized by symmetrical, bilateral lesions most frequently seen on the tongue, gingiva, and buccal mucosa. Although the exact etiopathogenesis is unknown, antigen-specific T-cell-mediated cytotoxicity is thought to be a contributing factor. Early diagnosis, therapy, and follow-up are necessary because the disease has a relapsing-remitting course and, in a small percentage of patients, can potentially change into malignancies, particularly in its erosive and atrophic forms.

Oral Lichen Planus can be managed using a variety of treatment approaches, depending on its severity and clinical manifestation. Asymptomatic lesions can be controlled with observation and proper oral hygiene techniques without needing medication. Topical anesthetics and anti-inflammatory drugs can be used to treat mild cases of OLP. Because of their strong anti-inflammatory properties, topical corticosteroids continue to be the cornerstone of treatment for more severe atrophic or erosive forms. However, many patients have numerous relapses and are unable to attain complete remission with monotherapy. Adverse effects, such as oral candidiasis, mucosal thinning, and altered taste perception, are also linked to long-term usage of corticosteroids.

There is no definitive and proven treatment for OLP, despite the wide range of available options, including systemic immunosuppressants like cyclosporine and azathioprine and more recent techniques like laser therapy and photodynamic therapy. Furthermore, there aren't many well-designed, randomized controlled trials that direct standardized care. Therefore, the majority of therapy alternatives are empirical. Patients resistant to corticosteroids present a therapeutic dilemma, necessitating the exploration of newer, targeted options. Janus kinase (JAK) inhibitors, especially tofacitinib, have recently shown promise in treating immune-mediated dermatological disorders, including LP. Tofacitinib suppresses the generation of inflammatory cytokines associated with OLP pathogenesis by modulating the JAK-STAT signaling pathway through the selective inhibition of JAK1 and JAK3. According to preliminary case series and pilot trials, tofacitinib, when applied topically or systemically, can significantly improve erosive OLP, particularly in steroid-refractory cases.

However, to the best of investigator's knowledge, no randomized controlled trials have systematically evaluated the add-on effect of tofacitinib to standard topical steroid therapy in OLP patients. This represents a significant gap in current literature, particularly in defining the role of combination therapies that might offer enhanced efficacy, reduce cumulative steroid doses, and mitigate steroid-related adverse effects. Therefore, this study aims to evaluate the efficacy and safety of tofacitinib as an add-on to topical triamcinolone therapy in patients with oral lichen planus. This trial seeks to provide robust evidence that could potentially redefine treatment paradigms for OLP.

Being tested
Tofacitinib 5 mg BID and Triamcinolone ointment, Placebo and Triamcinolone ointment
Keywords
Tofacitinib, Oral Lichen Planus, Randomized Controlled Trial, Placebo, IL 6
Medical subject headings
Lichen Planus, Oral

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tofacitinib 5 mg BID and Triamcinolone ointmentDrug

    Patients in the test group will get tofacitinib 5mg capsules twice daily as an add on to triamcinolone ointment

  • Placebo and Triamcinolone ointmentDrug

    Patients in the control group will receive identical looking capsules as placebo with triamcinolone ointment

Study groups in NCT07131813
Study groupRoleWhat they receive
Test: Capsule Tofacitinib + Triamcinolone ointmentExperimentalPatients in the test group will get Tofacitinib 5mg twice daily as an add on to topical triamcinolone ointment
Receives: Drug: Tofacitinib 5 mg BID and Triamcinolone ointment
Control: Placebo capsules + Triamcinolone ointmentActive comparatorPatients in the control group will get similar looking capsules containing placebo in addition to triamcinolone ointment
Receives: Drug: Placebo and Triamcinolone ointment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in oral mucosal disease severity score from baseline

    The change in oral mucosal disease severity score (maximum 106) will be evaluated using oral mucosal disease severity score questionnaire. Each item of the questionnaire yields a score of 0 to 106. A higher score depicts severe disease.

    Measured: 4 weeks and12 weeks

Secondary outcomes (5)
  1. Pain by Pain Visual Analogue Scale (VAS) score

    Change in Pain Visual Analogue Scale (VAS) score after treatment with triamcinolone ointment and capsule tofacitinib vs. triamcinolone ointment and capsule placebo at baseline, 4 weeks, and 12 weeks. The VAS consists of a 10 cm line, with two endpoints representing 0 ('no pain') and 10 ('pain as bad as it could possibly be'). Interpretation of the scores:0 = No pain, 2= Mild, 4 = Nagging, 6 = Miserable, 8 = intense, 10 = worst

    Measured: 4 weeks and12 weeks

  2. Severity by Physician global assessment of disease (PGA) Score

    Compare the proportion of patients achieving a reduction of Physician Global Assessment of Disease (PGA) score of 0 or a 2-grade reduction (minimum initial PGA 3) after treatment with triamcinolone ointment and capsule tofacitinib vs. triamcinolone ointment and capsule placebo at baseline, 4 weeks, and 12 weeks by using a 6-point disease severity scoring system. (0=clear, 1=almost clear, 2=mild, 3=moderate, 4=severe, 5=very severe).

    Measured: 4 weeks and 12 weeks

  3. Quality of life by using oral health-related quality of life score (ORAL HEALTH IMPACT PROFILE - 14 )

    Change in the oral health-related quality of life from baseline after 4 and 12 weeks. designed to assess patients' perception of the impact of oral disorders on their quality of life (QoL). The OHIP-14 scores can range from 0 to 56 and are calculated by summing the ordinal values for the 14 items. The domain scores can range from 0 to 8. Higher OHIP-14 scores indicate worse OHRQoL, and lower scores indicate better OHRQol

    Measured: 4 weeks and 12 weeks

  4. serum IL 6 level

    Change in serum IL-6 after treatment with ointment triamcinolone and capsule tofacitinib vs. ointment triamcinolone and capsule placebo. The levels of salivary and serum IL-6 were significantly higher among patients with OLP than among healthy control participants

    Measured: 12 weeks

  5. Incidence of treatment-emergent adverse events of both test and control group

    treatment-emergent adverse events in both the groups The adverse events in the patients are to be assessed by non-directive questioning at the time of the follow-up visit. Patients can access the investigators directly in case of any adverse events and report them. All adverse events irrespective of their previous reported status are to be recorded with details about nature, intensity, duration, measures taken, outcome, and causal relationship to tofacitinib, triamcinolone and placebo.

    Measured: 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Aug 2025
  2. Study start10 Oct 2025
  3. Primary completion1 Jan 2027 (estimated)
  4. Study completion1 Jun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07131813
Sponsor's protocol ID
IEC/AIIMSBBSR/PGThesis/2025/46
Status last verified
Nov 2025
First submitted
13 Aug 2025
Last updated
28 Nov 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sandhu S, Klein BA, Al-Hadlaq M, Chirravur P, Bajonaid A, Xu Y, Intini R, Hussein M, Vacharotayangul P, Sroussi H, Treister N, Sonis S. Oral lichen planus: comparative efficacy and treatment costs-a systematic review. BMC Oral Health. 2022 May 6;22(1):161. doi: 10.1186/s12903-022-02168-4.

    PubMed 35524296
  • Kulkarni S, Durham H, Glover L, Ather O, Phillips V, Nemes S, Cousens L, Blomgran P, Ambery P. Metabolic adverse events associated with systemic corticosteroid therapy-a systematic review and meta-analysis. BMJ Open. 2022 Dec 22;12(12):e061476. doi: 10.1136/bmjopen-2022-061476.

    PubMed 36549729
  • Rotaru D, Chisnoiu R, Picos AM, Picos A, Chisnoiu A. Treatment trends in oral lichen planus and oral lichenoid lesions (Review). Exp Ther Med. 2020 Dec;20(6):198. doi: 10.3892/etm.2020.9328. Epub 2020 Oct 14.

    PubMed 33123228
  • Qing M, Yang D, Shang Q, Peng J, Deng J, Lu J, Li J, Dan H, Zhou Y, Xu H, Chen Q. CD8+ tissue-resident memory T cells induce oral lichen planus erosion via cytokine network. Elife. 2023 Aug 9;12:e83981. doi: 10.7554/eLife.83981.

    PubMed 37555396
  • Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016 Oct;308(8):539-51. doi: 10.1007/s00403-016-1667-2. Epub 2016 Jun 27.

    PubMed 27349424
  • Katta R. Lichen planus. Am Fam Physician. 2000 Jun 1;61(11):3319-24, 3327-8.

    PubMed 10865927

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Tofacitinib 5 mg BID and Triamcinolone ointment in people with Oral Lichen Planus, run by All India Institute of Medical Sciences, Bhubaneswar at 1 site in India.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 28 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in India. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Monalisa Jena, MD (9438884193, pharm_monalisa@aiimsbhubaneswar.edu.in), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in oral mucosal disease severity score from baseline (time frame: 4 weeks and12 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07131813, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Nov 2025.

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