Therapeutic Potential of Enoxaparin in Lichen Planus: Exploring Reasons for Inconsistent Reports

Abstract

Lichen planus (LP) is an uncommon mucocutaneous inflammatory condition, that is immunologically mediated, typically pruritic and often recurs. The currently advocated therapies are either not highly effective or associated with severe side effects. Enoxaparin, a widely used anticoagulant, is composed of both anticoagulant and non-anticoagulant fragments. Enoxaparin is reported to have anti-inflammatory properties and it was found to be effective in LP. However, the results from clinical studies have varied substantially and, therefore, the clinical role of enoxaparin in LP remains uncertain. This review focuses on potential reasons for the reported inconsistent outcomes, as well as proposing solutions; these include identifying batch-to-batch inconsistency in the composition of enoxaparin. The potential therapeutic value of enoxaparin in LP must be explored using well-designed clinical trials, combined with experimental studies that focus on identifying the anti-inflammatory fragments of enoxaparin and elucidating the mechanism of action of these non-anticoagulant fragments.

Lichen planus: a comprehensive evidence‐based analysis of medical treatment

“…Apparently, clinical studies in the current literature have come out with inconsistent results: while some studies showed encouraging results, others had disappointing outcomes. Patel et al have recently investigated the potential reasons behind these discrepancies and they have suggested the following explanations: (i) the variable study designs, (ii) the use of subtherapeutic dose of enoxaparin and (iii) batch‐to‐batch inconsistency in the enoxaparin formulation. Better designed RCT are demanded to clarify the efficacy, safety and tolerability of enoxaparin in LP in future.…”

The Efficacy of Low-Dose Enoxaparin in Psoriasis

“…In the literature, there are mostly open-ended and nonrandomized studies involving a small number of patients and investigating the efficacy of subcutaneous enoxaparin in lichen planus (18)(19)(20)(21)(22). In the single randomized study, Iraji et al (23) compared the efficacy of low-dose enoxaparin with oral prednisolone and concluded that, although its therapeutic efficacy is lower than that of oral prednisolone, low-dose enoxaparin has therapeutic efficacy in lichen planus and that it may be a safer treatment alternative with fewer side effects.…”