Alefacept for Erosive Lichen Planus: A Case Series

Introduction: Erosive mucosal lichen planus is thought to be an autoimmune disease mediated by increased T-cell activation and proliferation. Alefacept is a biologic agent that selectively targets memory T cells.

Objective: To evaluate the preliminary efficacy and safety of alefacept in the treatment of moderate to severe mucosal LP.

Methods: Seven subjects were randomly selected to receive either alefacept 15 mg or placebo every week for 12 weeks. Endpoints of the case series were the Physician Global Assessment (PGA) of disease severity, mucosal pain (MP) severity, and itch severity (IS). Both subjects and investigators were blinded.

Results: Two of the subjects receiving alefacept achieved significant improvement during the study. There were no serious adverse events during the course of the study period.

Conclusions: In this small case series, alefacept may have conferred a modest therapeutic response in erosive lichen planus (LP). Larger multicenter prospective studies will be needed to determine whether alefacept can improve erosive LP in a statistically significant way.