Our experience with prurigo nodularis treated with dupilumab

Tilotta, Giovanna; Pistone, Giuseppe; Caruso, Paolo; Gurreri, Rosario; Castelli, E.; Curiale, Salvatrice; Caputo, Valentina; Bongiorno, Maria Rita

doi:10.1111/jdv.17046

Cited by 13 publications

(13 citation statements)

References 6 publications

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“…Significant improvements in health-related QOL scores from 15 to 6 and depression scores from 13 to 6 with three-month dupilumab treatment were reported in a case series of 10 patients [ 108 ]. Consistent results were found in patients with CNPG with an atopy history with NRS for pruritus from 10 to 3 after 4-month treatment [ 109 ]. A cohort study of 45 patients from eleven articles showed a significant reduction in NRS for pruritus from 8.58 ± 1.89 to 1.78 ± 2.29 after 4-month treatment [ 129 ].…”

Section: Treatmentsupporting

confidence: 76%

Chronic Nodular Prurigo: An Update on the Pathogenesis and Treatment

Wong

Yen

2022

IJMS

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Chronic nodular prurigo (CNPG) is a recalcitrant chronic itchy disorder that affects the quality of life. It can be triggered by multiple etiologies, such as atopic dermatitis, diabetes, and chronic renal diseases. The mechanisms of CNPG are complicated and involved the interaction of the cutaneous, immune, and nervous systems. Diverse immune cells, including eosinophils, neutrophils, T cells, macrophages, and mast cells infiltrated the lesional skin of CNPG, which initiated the inflammatory cytokines and pruritogens release. In addition, the interaction between the immune cells and activated peripheral sensory nerve fibers by neurotransmitters caused neuroinflammation in the skin and intractable itch. This itch-scratch vicious cycle of CNPG results in disease exacerbation. CNPG is difficult to treat with traditional therapies. Recently, great advances have been made in the pathophysiology of both inflammation and pruritus transmission in CNPG. In this review, we summarize the updated mechanisms and novel therapies for CNPG.

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Section: Treatmentsupporting

confidence: 76%

Chronic Nodular Prurigo: An Update on the Pathogenesis and Treatment

Wong

Yen

2022

IJMS

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“…The second reason was the presence of other forms than classic AD, mainly palmoplantar dyshidrosis and atopic prurigo. 23,24 In daily practice in France, moderate to severe AD is characterized by SCORAD >50 and IGA >4. (European Task Force on Atopic Dermatitis.…”

Section: Discussionmentioning

confidence: 99%

“…Instead of lower disease severity, IGA score and SCORAD were lower than required, probably because children had no treatment washout before starting dupilumab. The second reason was the presence of other forms than classic AD, mainly palmoplantar dyshidrosis and atopic prurigo 23,24 . In daily practice in France, moderate to severe AD is characterized by SCORAD >50 and IGA >4.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of dupilumab in the treatment of atopic dermatitis in children (6–11 years): data from a French multicentre retrospective cohort in daily practice

Lasek

Bellon

Mallet

et al. 2022

Acad Dermatol Venereol

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Background Dupilumab is the first biotherapy available for the treatment of moderate-to-severe childhood atopic dermatitis (AD).Objective The aim of this study was to evaluate the effectiveness and safety of dupilumab in daily practice.Methods Patients aged 6-11, who had received a first dose of dupilumab, were included in this multicentre retrospective cohort study. The primary endpoint was change in SCORAD after 3 months of treatment. Secondary endpoints were change in IGA score at 3 months, proportion of patients with SCORAD50 and SCORAD75, description of adverse events and proportion of children in our cohort who would be excluded from pivotal phase 3 clinical trial.Results Eighty patients were included. After 3 months of treatment, there was a significant decrease in SCORAD (mean: 21.8 AE 13.8 vs 53.9 AE 18.5; P < 0.0001) and IGA (1.3 AE 0.8 vs 3.5 AE 0.7; P < 0.0001). Conjunctivitis was observed in 11.3% (n = 9/80); three patients experienced dupilumab facial redness (DFR); 17.5% (n = 14/80) reported injection site reactions; 6.3% (n = 5/80) discontinued treatment. 61.2% (n = 49/80) children were ineligible in the phase 3 trial. Limitations There is no control group. Because it was a real life study based on information from patient medical records in a French multicentre cohort, we cannot rule out the presence of reporting bias generated by the use of patient reported characteristics and missing information.

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“…Additionally, the LIBERTY AD CAFÉ trial evaluated dupilumab 300 mg administered weekly or fortnightly to adults with an inadequate not an indication for dupilumab. Published clinical cases and the case series (Table 1) bring together 118 patients diagnosed with chronic prurigo nodularis [77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96] and include patients with and without a history of atopy. Only one involved a child.…”

Section: Approved Indications For Dupilumabmentioning

confidence: 99%

Dupilumab: A Review of Present Indications and Off-Label Uses

Muñoz-Bellido¹,

Moreno²,

Dávila³

2022

J Investig Allergol Clin

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Recent advances in understanding T2 inflammation have broadened the diseases in which T2 inflammation can be involved. Dupilumab is a recently developed monoclonal antibody blocking the signaling of both IL-4 and IL13, two crucial cytokines of the T2 responses. New possible indications are increasingly exploring. Among them are skin diseases, such as prurigo nodularis, nummular eczema, allergic contact dermatitis, chronic hand eczema, spontaneous chronic urticaria, bullous pemphigoid, alopecia areata, and Netherton syndrome, among other several cutaneous diseases. Also, respiratory diseases, such as allergic bronchopulmonary aspergillosis, chronic eosinophilic pneumonia, and allergic rhinitis. In addition, eosinophilic gastrointestinal disorders, particularly eosinophilic esophagitis, and food allergy are two more research fields. Here we review the published data and clinical trials about the use of dupilumab in these disorders.

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Our experience with prurigo nodularis treated with dupilumab

Cited by 13 publications

References 6 publications

Chronic Nodular Prurigo: An Update on the Pathogenesis and Treatment

Chronic Nodular Prurigo: An Update on the Pathogenesis and Treatment

Effectiveness and safety of dupilumab in the treatment of atopic dermatitis in children (6–11 years): data from a French multicentre retrospective cohort in daily practice

Dupilumab: A Review of Present Indications and Off-Label Uses

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