Four Cases of Prurigo Nodularis Requiring Nemolizumab due to Persistent Pruritus or Lesions after Dupilumab Treatment
DOI:
https://doi.org/10.2340/actadv.v105.43419Keywords:
nemolizumab, dupilumab, prurigo nodularis, peak pruritus numerical rating scale, prurigo nodularis investigator’s global assessmentDownloads
References
Pereira MP, Steinke, S, Zeidler C, Forner C, Riepe C, Augustin M, et al. European Academy of Dermatology and Venereology European prurigo project: expert consensus on the definition, classification and terminology of chronic prurigo. J Eur Acad Dermatol Venereol 2018; 32: 1059-1065.
https://doi.org/10.1111/jdv.14570 DOI: https://doi.org/10.1111/jdv.14570
Leis M, Fleming P, Lynde CW. Prurigo nodularis: review and emerging treatments. Skin Therapy Lett 2021; 26: 5–8.
Williams KA, Huang AH, Belzberg M, Kwatra SG. Prurigo nodularis: pathogenesis and management. J Am Acad Dermatol 2020; 83: 1567–1575.
https://doi.org/10.1016/j.jaad.2020.04.182 DOI: https://doi.org/10.1016/j.jaad.2020.04.182
Kwatra SG, Ständer S, Yosipovitch G, Kim BS, Levit NA, O’Malley JT. Pathophysiology of prurigo nodularis: neuroimmune dysregulation and the role of Type 2 inflammation. J Invest Dermatol 2025; 145: 249–256.
https://doi.org/10.1016/j.jid.2024.06.1276 DOI: https://doi.org/10.1016/j.jid.2024.06.1276
Yosipovitch G, Rosen JD, Hashimoto T. Itch: from mechanism to (novel) therapeutic approaches. J Allergy Clin Immunol 2018; 142: 1375–1390.
https://doi.org/10.1016/j.jaci.2018.09.005 DOI: https://doi.org/10.1016/j.jaci.2018.09.005
Haas S, Capellino S, Phan NQ, Böhm M, Luger TA, Straub RH, et al. Low density of sympathetic nerve fibers relative to substance P-positive nerve fibers in lesional skin of chronic pruritus and prurigo nodularis. J Dermatol Sci 2010; 58: 193–197.
https://doi.org/10.1016/j.jdermsci.2010.03.020 DOI: https://doi.org/10.1016/j.jdermsci.2010.03.020
Nakajima S, Yonekura S, Nakamizo S, Egawa, G, Kabashima K. Dupilumab as a novel treatment option for prurigo nodularis. J Allergy Clin Immunol 2023; 152: 870–872.
https://doi.org/10.1016/j.jaci.2023.08.011 DOI: https://doi.org/10.1016/j.jaci.2023.08.011
Yosipovitch G, Mollanazar N, Ständer S, Kwatra SG, Kim BS, Laws E, et al. Dupilumab in patients with prurigo nodularis: two randomized, double-blind, placebo-controlled phase 3 trials. Nat Med 2023; 29: 1180–1190.
https://doi.org/10.1038/s41591-023-02320-9 DOI: https://doi.org/10.1038/s41591-023-02320-9
Paganini C, Talamonti M, Maffei V, Di Raimondo C, Bianchi L, Galluzzo M. Dupilumab for treatment of prurigo nodularis: real-life effectiveness for up to 84 weeks. J Clin Med 2024; 13: 878.
https://doi.org/10.3390/jcm13030878 DOI: https://doi.org/10.3390/jcm13030878
US Food and Drug Administration. Novel drug approvals for 2024. Available from: https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2024
Kwatra SG, Yosipovitch G, Legat FJ, Reich A, Paul C, Simon D, et al. Phase 3 trial of nemolizumab in patients with prurigo nodularis. N Engl J Med 2023; 389: 1579–1589.
https://doi.org/10.1056/NEJMoa2301333 DOI: https://doi.org/10.1056/NEJMoa2301333
Ständer S, Yosipovitch G, Lacour JP, Legat FJ, Paul C, Reich A, et al. Nemolizumab efficacy in prurigo nodularis: onset of action on itch and sleep disturbances. J Eur Acad Dermatol Venereol 2022; 36: 1820–1825.
https://doi.org/10.1111/jdv.18377 DOI: https://doi.org/10.1111/jdv.18377
Kwatra SG, Bordeaux ZA, Parthasarathy V, Kollhoff AL, Alajmi A, Pritchard T, et al. Efficacy and safety of abrocitinib in prurigo nodularis and chronic pruritus of unknown origin: a nonrandomized controlled trial. JAMA Dermatol 2024; 160: 717–724.
https://doi.org/10.1001/jamadermatol.2024.1464 DOI: https://doi.org/10.1001/jamadermatol.2024.1464
Kawai R, Ichimasu N, Katagiri K. IL-4 and IL-13 are not involved in IL-31-induced itch-associated scratching behaviour in mice. Exp Dermatol 2024; 33: e15115.
https://doi.org/10.1111/exd.15115 DOI: https://doi.org/10.1111/exd.15115
Sardana K, Mathachan SR, Muddebihal A, Agrawal D, Ahuja A. Translating tissue expression of STAT 1, 3 and 6 in prurigo nodularis to clinical efficacy of oral tofacitinib: a prospective single-arm investigational study. Indian J Dermatol Venereol Leprol 2025; 17: 1–6.
https://doi.org/10.25259/IJDVL_1017_2024 DOI: https://doi.org/10.25259/IJDVL_1017_2024
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