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A Study to Evaluate the Efficacy and Safety of Ruxolitinib Cream in Participants With Lichen Sclerosus

A Phase 2, Randomized, Double-Blind, Vehicle-Controlled, Study of the Efficacy and Safety of Ruxolitinib Cream in Participants With Lichen Sclerosus

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05593445
Enrollment
61
Registered
2022-10-25
Start date
2022-11-18
Completion date
2023-12-21
Last updated
2024-09-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Lichen Sclerosus

Keywords

Lichen Sclerosus, Skin Diseases, 18424, Ruxolitinib, topical cream, vulvar disease

Brief summary

The purpose of this study is to evaluate the efficacy and safety of Ruxolitinib cream in participants With Lichen Sclerosus. This is randomized, double-blind, vehicle-controlled (DBVC) study with a DBVC period of 12 weeks followed by an open label period (OLE) period of 12 weeks.

Interventions

DRUGRuxolitinib cream

Ruxolitinib cream is a topical formulation applied as a thin film to affected areas.

DRUGVehicle cream

Vehicle cream is matching in appearance to ruxolitinib cream and is to be applied in the same manner as ruxolitinib cream.

Sponsors

Incyte Corporation
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Intervention model description

Study will be a 12 week double-blind period followed by a 12 week open label period.

Eligibility

Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Biopsy-proven LS in the anogenital area. * Baseline IGA score ≥ 2 for LS. * Baseline Itch NRS score ≥ 4 in anogenital area. * Willingness to avoid pregnancy.

Exclusion criteria

* Participants who do not have LS involving anogenital area. * Concurrent conditions and history of other diseases: 1. Are suspected clinically (or confirmed diagnostically) of having alternative causes of vaginal symptoms including: candidiasis, chlamydia trachomatis, trichomonas vaginalis, neisseria gonorrhoeae, bacterial vaginosis, or herpes simplex. 2. Have active genital/vulvar lesions at screening and Day 1, not related to LS 3. Chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 2 weeks before baseline. * Laboratory values outside of the protocol-defined criteria * Pregnant or lactating participants or those considering pregnancy during the period of their study participation.. * Other

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With ITCH4 at Week 12Baseline; Week 12ITCH4 response was defined as a ≥4-point improvement from Baseline in by-visit Itch Numeric Rating Scale (NRS) score. The Itch NRS is a daily participant-reported measure (24-hour recall) of the worst level of itch intensity. Participants rated itch severity of their lichen sclerosus by selecting a number from 0 (no itch) to 10 (worst imaginable itch) that best described the worst level of itch they experienced in the past 24 hours.

Secondary

MeasureTime frameDescription
Change From Baseline in the Skin Pain NRS Score at Week 12Baseline; Week 12Participants were instructed to complete and record the Skin Pain NRS in a diary each evening beginning on the day of screening through Week 12 or treatment discontinuation. Participants rated their pain, which included all types of pain (e.g., burning, tearing, pulling, stabbing, etc.) severity of lichen sclerosus by selecting a number from 0 (no pain) to 10 (worst imaginable pain) that best described the worst level of pain they experienced in the past 24 hours.
Time to Achieve ITCH4up to 99.0 daysITCH4 response was defined as a ≥4-point improvement from Baseline in by-visit Itch Numeric Rating Scale (NRS) score. The Itch NRS is a daily participant-reported measure (24-hour recall) of the worst level of itch intensity. Participants rated itch severity of their lichen sclerosus by selecting a number from 0 (no itch) to 10 (worst imaginable itch) that best described the worst level of itch they experienced in the past 24 hours.
Number of Participants With Any Treatment-emergent Adverse Event (TEAE) During the Double-blind, Vehicle-controlled Periodfrom Baseline to Week 12 plus 30 daysAn adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not it is considered drug related. An AE could therefore have been any unfavorable or unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drug. A TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug.
Number of Participants With Any ≥Grade 3 TEAE During the Double-blind, Vehicle-controlled Periodfrom Baseline to Week 12 plus 30 daysA TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug. The severity of AEs was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 (v5.0) Grades 1 through 5. The investigator made an assessment of intensity for each AE and SAE reported during the study and assigned it to 1 of the following categories: Grade 1: mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; treatment not indicated. Grade 2: moderate; minimal, local, or noninvasive treatment indicated; limiting age-appropriate activities of daily living. Grade 3: severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily living. Grade 4: life-threatening consequences; urgent treatment indicated. Grade 5: fatal.
Number of Participants With Any TEAE During the Open-label Extension Periodfrom Week 12 to Week 24 plus 30 daysAn AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not it is considered drug related. An AE could therefore have been any unfavorable or unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drug. A TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug.
Change From Baseline in the Clinical Lichen Sclerosus Score (CLISSCO) at Week 12Baseline; Week 12The CLISSCO is a validated tool to assess disease severity in vulvar lichen sclerosus. The Clinical Lichen Sclerosus Score consists of 12 items divided into 3 sections: symptoms (3 items; likely reversible \[i.e., itch, pain, dysuria\]); signs (3 items; possibly reversible \[i.e., whitening, petechiae/ecchymosis, fissures\]); and architectural changes (6 items; irreversible \[i.e., skin fusion, perianal involvement, etc.\]). All symptoms, signs, and architectural changes were rated on a 4-point Likert scale: 0 (absent), 1 (mild), 2 (moderate), and 3 (severe). The investigator documented the score of each of the 12 items; the CLISSCO was calculated by summing the score of each question, with a maximum score of 36 and a minimum score of 0. The higher the score, the more severe the disease. Additionally, the total score for each of the 3 sections (symptoms, signs, and architectural changes) was summarized by summing the scores of the questions in each section.
Number of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Double-blind, Vehicle-controlled Periodfrom Baseline to Week 12 plus 30 daysThe investigator determined if a clinical laboratory test value was clinically meaningful.
Number of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Double-blind, Vehicle-controlled Periodfrom Baseline to Week 12 plus 30 daysThe investigator determined if a clinical laboratory test value was clinically meaningful.
Number of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Open-label Extension Periodfrom Week 12 to Week 24 plus 30 daysThe investigator determined if a clinical laboratory test value was clinically meaningful.
Number of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Open-label Extension Periodfrom Week 12 to Week 24 plus 30 daysThe investigator determined if a clinical laboratory test value was clinically meaningful.
Number of Participants With Any ≥Grade 3 TEAE During the Open-label Extension Periodfrom Week 12 to Week 24 plus 30 daysA TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug. The severity of AEs was assessed using the CTCAE v5.0 Grades 1 through 5. The investigator made an assessment of intensity for each AE and SAE reported during the study and assigned it to 1 of the following categories: Grade 1: mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; treatment not indicated. Grade 2: moderate; minimal, local, or noninvasive treatment indicated; limiting age-appropriate activities of daily living. Grade 3: severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily living. Grade 4: life-threatening consequences; urgent treatment indicated. Grade 5: fatal.

Countries

Canada, United States

Participant flow

Pre-assignment details

A total of 61 participants were randomized into the study. All randomized participants (Intent-to-Treat Population) applied study drug at least once (Safety Population), and 56 participants applied ruxolitinib 1.5% cream at least once during the Open-label Extension (OLE) Period (OLE-Evaluable Population).

Participants by arm

ArmCount
DBVC Period: Ruxolitinib Cream 1.5% BID
Participants applied ruxolitinib 1.5% cream twice daily (BID) for 12 weeks.
31
DBVC Period: Vehicle Cream BID
Participants applied matching vehicle cream BID for 12 weeks.
30
Total61

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
12-Week DBVC PeriodAdverse Event1000
12-Week DBVC PeriodDid Not Meet Eligibility Criteria1000
12-Week DBVC PeriodPhysician Decision0100
12-Week DBVC PeriodProtocol Violation0100
12-Week DBVC PeriodWithdrawal by Subject0100
12-Week Open-Label Extension PeriodAdverse Event0011
12-Week Open-Label Extension PeriodLost to Follow-up0011
12-Week Open-Label Extension PeriodWithdrawal by Subject0010

Baseline characteristics

CharacteristicDBVC Period: Vehicle Cream BIDTotalDBVC Period: Ruxolitinib Cream 1.5% BID
Age, Continuous61.9 years
STANDARD_DEVIATION 12.25
60.9 years
STANDARD_DEVIATION 11.71
60.0 years
STANDARD_DEVIATION 11.28
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants8 Participants3 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
25 Participants53 Participants28 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
5 Participants5 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
25 Participants56 Participants31 Participants
Sex: Female, Male
Female
30 Participants61 Participants31 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 580 / 30
other
Total, other adverse events
10 / 586 / 30
serious
Total, serious adverse events
0 / 581 / 30

Outcome results

Primary

Percentage of Participants With ITCH4 at Week 12

ITCH4 response was defined as a ≥4-point improvement from Baseline in by-visit Itch Numeric Rating Scale (NRS) score. The Itch NRS is a daily participant-reported measure (24-hour recall) of the worst level of itch intensity. Participants rated itch severity of their lichen sclerosus by selecting a number from 0 (no itch) to 10 (worst imaginable itch) that best described the worst level of itch they experienced in the past 24 hours.

Time frame: Baseline; Week 12

Population: Intent-to-Treat (ITT) Population: all randomized participants. Treatment groups were defined according to the treatment assignment at the time of randomization regardless of the actual study drug the participant might have taken. Only those participants with a Baseline ITCH NRS Score ≥4 were analyzed. Missing post-baseline values were imputed as Non-Responders at Week 12.

ArmMeasureValue (NUMBER)
DBVC Period: Ruxolitinib Cream 1.5% BIDPercentage of Participants With ITCH4 at Week 1235.7 percentage of participants
DBVC Period: Vehicle Cream BIDPercentage of Participants With ITCH4 at Week 1240.0 percentage of participants
p-value: 0.73795% CI: [0.29, 2.41]Chi-squared
95% CI: [-29.2, 20.7]
Secondary

Change From Baseline in the Clinical Lichen Sclerosus Score (CLISSCO) at Week 12

The CLISSCO is a validated tool to assess disease severity in vulvar lichen sclerosus. The Clinical Lichen Sclerosus Score consists of 12 items divided into 3 sections: symptoms (3 items; likely reversible \[i.e., itch, pain, dysuria\]); signs (3 items; possibly reversible \[i.e., whitening, petechiae/ecchymosis, fissures\]); and architectural changes (6 items; irreversible \[i.e., skin fusion, perianal involvement, etc.\]). All symptoms, signs, and architectural changes were rated on a 4-point Likert scale: 0 (absent), 1 (mild), 2 (moderate), and 3 (severe). The investigator documented the score of each of the 12 items; the CLISSCO was calculated by summing the score of each question, with a maximum score of 36 and a minimum score of 0. The higher the score, the more severe the disease. Additionally, the total score for each of the 3 sections (symptoms, signs, and architectural changes) was summarized by summing the scores of the questions in each section.

Time frame: Baseline; Week 12

Population: ITT Population. Only participants with available data were analyzed. Mixed Model Repeated Measures (MMRM) model: response variable = treatment + visit + treatment by visit.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
DBVC Period: Ruxolitinib Cream 1.5% BIDChange From Baseline in the Clinical Lichen Sclerosus Score (CLISSCO) at Week 12-5.79 scores on a scaleStandard Error 0.8
DBVC Period: Vehicle Cream BIDChange From Baseline in the Clinical Lichen Sclerosus Score (CLISSCO) at Week 12-3.03 scores on a scaleStandard Error 0.82
p-value: 0.018895% CI: [-5.05, -0.47]Mixed Model Repeated Measures (MMRM)
Secondary

Change From Baseline in the Skin Pain NRS Score at Week 12

Participants were instructed to complete and record the Skin Pain NRS in a diary each evening beginning on the day of screening through Week 12 or treatment discontinuation. Participants rated their pain, which included all types of pain (e.g., burning, tearing, pulling, stabbing, etc.) severity of lichen sclerosus by selecting a number from 0 (no pain) to 10 (worst imaginable pain) that best described the worst level of pain they experienced in the past 24 hours.

Time frame: Baseline; Week 12

Population: ITT Population. Only participants with available data were analyzed. No imputation was performed for missing values. MMRM model: response variable = treatment + visit + treatment by visit.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
DBVC Period: Ruxolitinib Cream 1.5% BIDChange From Baseline in the Skin Pain NRS Score at Week 12-3.22 scores on a scaleStandard Error 0.5
DBVC Period: Vehicle Cream BIDChange From Baseline in the Skin Pain NRS Score at Week 12-2.70 scores on a scaleStandard Error 0.52
p-value: 0.467495% CI: [-1.96, 0.91]MMRM
Secondary

Number of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Double-blind, Vehicle-controlled Period

The investigator determined if a clinical laboratory test value was clinically meaningful.

Time frame: from Baseline to Week 12 plus 30 days

Population: Safety Population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Double-blind, Vehicle-controlled Period0 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Double-blind, Vehicle-controlled Period0 Participants
Secondary

Number of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Open-label Extension Period

The investigator determined if a clinical laboratory test value was clinically meaningful.

Time frame: from Week 12 to Week 24 plus 30 days

Population: Open-label Extension Evaluable Population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Open-label Extension Period0 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Clinical Laboratory Test Results During the Open-label Extension Period0 Participants
Secondary

Number of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Double-blind, Vehicle-controlled Period

The investigator determined if a clinical laboratory test value was clinically meaningful.

Time frame: from Baseline to Week 12 plus 30 days

Population: Safety Population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Double-blind, Vehicle-controlled Period0 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Double-blind, Vehicle-controlled Period0 Participants
Secondary

Number of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Open-label Extension Period

The investigator determined if a clinical laboratory test value was clinically meaningful.

Time frame: from Week 12 to Week 24 plus 30 days

Population: Open-label Extension Evaluable Population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Open-label Extension Period0 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any Clinically Meaningful Changes Over Time in Vital Sign Values During the Open-label Extension Period0 Participants
Secondary

Number of Participants With Any ≥Grade 3 TEAE During the Double-blind, Vehicle-controlled Period

A TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug. The severity of AEs was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 (v5.0) Grades 1 through 5. The investigator made an assessment of intensity for each AE and SAE reported during the study and assigned it to 1 of the following categories: Grade 1: mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; treatment not indicated. Grade 2: moderate; minimal, local, or noninvasive treatment indicated; limiting age-appropriate activities of daily living. Grade 3: severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily living. Grade 4: life-threatening consequences; urgent treatment indicated. Grade 5: fatal.

Time frame: from Baseline to Week 12 plus 30 days

Population: Safety Population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any ≥Grade 3 TEAE During the Double-blind, Vehicle-controlled Period1 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any ≥Grade 3 TEAE During the Double-blind, Vehicle-controlled Period0 Participants
Secondary

Number of Participants With Any ≥Grade 3 TEAE During the Open-label Extension Period

A TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug. The severity of AEs was assessed using the CTCAE v5.0 Grades 1 through 5. The investigator made an assessment of intensity for each AE and SAE reported during the study and assigned it to 1 of the following categories: Grade 1: mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; treatment not indicated. Grade 2: moderate; minimal, local, or noninvasive treatment indicated; limiting age-appropriate activities of daily living. Grade 3: severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily living. Grade 4: life-threatening consequences; urgent treatment indicated. Grade 5: fatal.

Time frame: from Week 12 to Week 24 plus 30 days

Population: Open-label Extension Evaluable Population

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any ≥Grade 3 TEAE During the Open-label Extension Period1 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any ≥Grade 3 TEAE During the Open-label Extension Period0 Participants
Secondary

Number of Participants With Any TEAE During the Open-label Extension Period

An AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not it is considered drug related. An AE could therefore have been any unfavorable or unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drug. A TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug.

Time frame: from Week 12 to Week 24 plus 30 days

Population: Open-label Extension Evaluable Population: all participants who applied ruxolitinib 1.5% cream at least once during the Open-label Extension Period

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any TEAE During the Open-label Extension Period13 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any TEAE During the Open-label Extension Period11 Participants
Secondary

Number of Participants With Any Treatment-emergent Adverse Event (TEAE) During the Double-blind, Vehicle-controlled Period

An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not it is considered drug related. An AE could therefore have been any unfavorable or unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drug. A TEAE was defined as an AE either reported for the first time or the worsening of a pre-existing event after the first application of study drug.

Time frame: from Baseline to Week 12 plus 30 days

Population: Safety Population: all participants who applied ruxolitinib 1.5% cream or vehicle cream at least once. Treatment groups for this population were determined according to the actual treatment the participant applied on Day 1 regardless of assigned treatment group.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
DBVC Period: Ruxolitinib Cream 1.5% BIDNumber of Participants With Any Treatment-emergent Adverse Event (TEAE) During the Double-blind, Vehicle-controlled Period14 Participants
DBVC Period: Vehicle Cream BIDNumber of Participants With Any Treatment-emergent Adverse Event (TEAE) During the Double-blind, Vehicle-controlled Period12 Participants
Secondary

Time to Achieve ITCH4

ITCH4 response was defined as a ≥4-point improvement from Baseline in by-visit Itch Numeric Rating Scale (NRS) score. The Itch NRS is a daily participant-reported measure (24-hour recall) of the worst level of itch intensity. Participants rated itch severity of their lichen sclerosus by selecting a number from 0 (no itch) to 10 (worst imaginable itch) that best described the worst level of itch they experienced in the past 24 hours.

Time frame: up to 99.0 days

Population: ITT Population. Only those participants achieving a ≥4-point improvement in daily Itch NRS score from Baseline were analyzed.

ArmMeasureValue (MEDIAN)
DBVC Period: Ruxolitinib Cream 1.5% BIDTime to Achieve ITCH435.0 days
DBVC Period: Vehicle Cream BIDTime to Achieve ITCH428.0 days
p-value: 0.907295% CI: [0.503, 1.869]Log Rank

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026