INDIVIDUAL ARTICLE: New Horizons in Our Understanding of Prurigo Nodularis and Its Management

December 2023 | Volume 22 | Issue 12 | SF365502s4 | Copyright © December 2023


Published online November 28, 2023

Gil Yosipovitch MD

Dr Phillip Frost Department of Dermatology and Miami Itch Center Miller School of Medicine University of Miami, Miami, FL

Elmariah et al reviews the current treatments and emerging therapies for PN.9 The authors highlight the importance of assessing pruritus intensity, and disease burden, and comorbid medical disorders. Elmariah et al emphasize that treatment goals should address first and foremost the resolution of itch followed by improvement in nodules.9 Elmariah et al describe the exciting recent phase 3 studies of targeted treatments for Type 2 cytokines including dupilumab and nemolizumab, as well as other phase 2 studies including vixarelimab.9,11 Elmariah et al also cover the landscape of drugs targeting the neural pathways, such as nalbuphine and non-specific drugs with nerve pain medications such as GABAergic drugs and Serotonin and norepinephrine reuptake inhibitors (SNRIs).9

In conclusion, PN patients are facing a new era where their disease is effectively treatable with current targeted treatments as well as new options on the horizon.

DISCLOSURE

Gil Yosipovitch has served as an advisory board member for Abbvie, Arcutis, Escient Health, Eli Lilly, Galderma, LEO Pharma, Novartis, Pfizer, Pierre Fabre, Regeneron Pharmaceuticals Inc., Sanofi, Vifor, GSK, and Kamari; received grants/research funding from Eli Lilly, LEO Pharma, Novartis, Pfizer, Galderma, Escient, Sanofi Regeneron, and Celldex; and as an investigator for Regeneron Pharmaceuticals Inc., and Sanofi.

REFERENCES

  1. Hyde JN, Montgomery FH. A Practical Treatise on Disease of the Skin for the Use of Students and Practitioners. Philadelphia, PA: Lea and Febiger. 1909;174-175. 
  2. Yosipovitch G, Mollanazar N, Ständer S, et al. Dupilumab in patients with prurigo nodularis: two randomized, double-blind, placebo-controlled phase 3 trials. Nat Med. 2023;29(5):1180-1190. doi: 10.1038/s41591-023-02320-9. PMID: 37142763; PMCID: PMC10202800.
  3. Kwatra SG, Yosipovitch G, Legat FJ, et al. Phase 3 Trial of Nemolizumab in Patients with Prurigo Nodularis. N Engl J Med. 2023;389(17):1579-1589
  4. Weisshaar E, Szepietowski JC, Bernhard JD, et al. Efficacy and safety of oral nalbuphine extended release in prurigo nodularis: results of a phase 2 randomized controlled trial with an open-label extension phase. J Eur Acad Dermatol Venereol. 2022;36:453–461
  5. Issa NT, Riva H, Jafferany M. Prurigo nodularis: current clinicopathologic overview and psychodermatological perspectives. J Drugs Dermatol. 2023;22:12(Suppl 2):s6-11.
  6. Hashimoto T, Nattkemper LA, Kim HS, et al. Dermal periostin: a new player in itch of prurigo nodularis. Acta Derm Venereol. 2021;101(1):adv00375.
  7. Choragudi S, Yosipovitch G. Prurigo nodularis is highly linked with neural sensitization disorders of pain among hospitalized adults in the United States - National Inpatient Sample 2016-2019. Br J Dermatol. 2023;189(2):240-242
  8. Kwatra G, Chisolm SS, Puerta Durango KS, et al. Patient journey and the burden of systemic comorbidities and sequalae in prurigo nodularis. J Drugs Dermatol. 2023;22:12(Suppl 2):s12-14.
  9. Elmariah SB, Tao L, Valdes-Rodriguez R, et al. Management of prurigo nodularis. J Drugs Dermatol. 2023;22:12(Suppl 2):s15-22.
  10. Boozalis E, Tang O, Patel S, et al. Ethnic differences and comorbidities of 909 prurigo nodularis patients. J Am Acad Dermatol. 2018;79(4):714-719.e3. doi: 10.1016/j.jaad.2018.04.047. 
  11. Sofen H, Bissonnette R, Yosipovitch G, et al. Efficacy and safety of vixarelimab, a human monoclonal oncostatin M receptor β antibody, in moderate-to-severe prurigo nodularis: a randomised, double-blind, placebo-controlled, phase 2a study. E Clinical Medicine. 2023;57:101826. doi: 10.1016/j.eclinm.2023.101826. PMID: 36816342; PMCID: PMC9932343.

AUTHOR CORRESPONDENCE

Gil Yosipovitch MD yosipog@gmail.com
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