Dupilumab effective for chronic nodular prurigo

Dupilumab is effective for reducing itch and improving skin lesions in patients with chronic nodular prurigo (CNPG), a new study has found.

Researchers conducted a retrospective multicentre analysis of 27 adult CNPG patients (mean age, 52.0±14.9 years; 16 women) who received 16 weeks of dupilumab treatment. Outcome measures included the numerical rating scale (NRS) for itch and sleeplessness, and the Investigator Global Assessment Scale (IGA).

Almost half of the participants had had a personal history of atopic dermatitis (AD) or other AD manifestations, and patients had had CNPG for an average of 13.7±13.6 years. All participants had previously been treated with at least one systemic treatment, and thirteen had failed at least three systemic treatments before dupilumab.

After 4 weeks of treatment, more than half of the patients showed a reduction in IGA score of at least two grades, and there were significant drops in itch and sleeplessness NRS scores (p<0.001). On the other hand, four patients dropped out at this point due to lack of efficacy or worsening CNPG.

Of the 23 remaining patients by week 16, 47.8 percent (n=11) were deemed to have very mild disease by IGA, while 21.7 percent (n=5) had mild disease. Nineteen participants (82.6 percent) achieved an ≥2-grade decrease in IGA.

Relative to baseline, itch NRS dropped from 8.9 to 2.7, while sleeplessness NRS decreased from 8.2 to 1.7 (p<0.001 for both). Ten patients were able to reach 36 weeks of treatment with sustained clinical efficacy.