Challenges in Clinical Research and Care in Pruritus

Abstract

Itch lasting for 6 weeks or more is considered chronic and represents a high burden for those affected. Various aspects of chronic itch, including the underlying origin of the itch, symptoms, skin manifestations, response to therapies and impairment of quality of life vary from patient to patient, constituting a challenge for clinicians and clinical researchers. Unmet needs, such as the standardization of experimental and clinical research protocols, diagnostic procedures and therapeutic regimens, as well as a better understanding of associated burdens and the development of novel effective therapies should be targeted by physicians and researchers dealing with chronic itch. Chronic pruritus is a frequent global condition. The pathophysiology, underlying aetiology, clinical manifestation, associated burden and response to therapy of chronic pruritus varies from patient to patient, making clinical research and management of this condition challenging. There are still several unmet needs, such as the need to standardize translational research protocols, diagnostic and therapeutic procedures and to enhance the knowledge of the humanistic and economic burden associated with chronic pruritus. Basic and clinical research is of the utmost importance to target these matters. Clinical research has the potential to identify new relevant mechanisms in affected patients, which may lead to identification of novel therapy targets. This article discusses in depth current shortcomings in the daily care of patients with chronic pruritus and the challenges clinical researchers and physicians treating chronic pruritus face in addressing these matters.

Interleukin-31 as a Clinical Target for Pruritus Treatment

“…Since current anti-pruritic treatments are often ineffective (99,100), affected patients are in urgent need of new therapies (101,102). As a result, drug development targeting the IL-31 pathway is evolving rapidly.…”

Major Risk Factors Analysis of Pruritus Complicated by Type 2 Diabetes Mellitus and the Effect of Comprehensive Nursing Intervention

“…Although pruritus in DM patients is not a direct threat to patients' lives, it has a serious impact on patient's quality of life and physical and mental health, reduces patients' compliance with treatment and is detrimental to the control of their condition, thus increasing their long-term mortality ( 10 , 11 ). In recent years, there has been an increasing number of research treatments for pruritus in patients with MD, but with little success ( 12 , 13 ). Therefore, analysis of the causes of pruritus in DM patients, establishment of a suitable assessment system, and interventions targeting them to evaluate the effects of interventions have great clinical and social significance in improving the quality of life of DP patients.…”

Contribution of Central and Peripheral Glial Cells in the Development and Persistence of Itch: Therapeutic Implication of Glial Modulation

“…Its complex pathogenesis, together with numerous contributing factors, has made CI a medical challenge to treat, and independent of the type of therapy, a care gap exists, with insufficient itch relief [1,14]. Recent investigations in pruritus and antipruritic have revealed a number of mechanistic aspects of CI and, consequently, new possibilities for novel therapeutic options [15,16].…”