The self‐assessed psychological comorbidities of prurigo in European patients: a multicentre study in 13 countries

Brenaut, E.; Halvorsen, Jon Anders; Dalgard, Florence; Lien, Lars; Balieva, Flora; Sampogna, Francesca; Linder, Dennis; Evers, Andrea; Jemec, Gregor B. E.; Gieler, Uwe; Szepietowski, Jacek C.; Poot, F.; Altunay, İlknur Kıvanç; Finlay, Andrew Y.; Salek, Sam; Szabó, Csanád; Lvov, A. N.; Marrón, S.E.; Tómas-Aragonés, Lucía; Kupfer, Jörg; Miséry, Laurent

doi:10.1111/jdv.15145

Cited by 59 publications

(52 citation statements)

References 24 publications

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“…Our patients had a long duration of CNPG, had previous ineffective therapies, and were exposed for the first time to a study procedure. Also, the burden of patients with CNPG is higher than in other skin diseases (37) as they have more comorbidities with higher impact on quality of life (38). Taken together, these facts could explain why there is a high level of negative expectation and a lack of trust in novel therapies.…”

Section: Discussionmentioning

confidence: 99%

Aprepitant in Anti-histamine-refractory Chronic Nodular Prurigo: A Multicentre, Randomized, Double-blind, Placebo-controlled, Cross-over, Phase-II trial (APREPRU)

Tsianakas¹,

Zeidler²,

Riepe³

et al. 2019

Acta Derm Venerol

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Chronic nodular prurigo is characterized by multiple highly pruritic cutaneous nodules and a high impact on quality of life. The molecule substance P appears to play a significant role in the pathway of chronic pruritus. This randomized, double-blind, placebo-controlled, cross-over trial aimed to find out if using the drug aprepitant to block the substance P pathway could influence chronic pruritus in chronic nodular prurigo. However, the results showed no significant difference between aprepitant and placebo. The aim of this multicentre, randomized, double-blind, placebo-controlled, cross-over, phase-II study was to determine the antipruritic effect of aprepitant vs. placebo in 58 patients with anti-histamine-refractory chronic pruritus in chronic nodular prurigo. Patients were randomized to receive either first oral aprepitant 80 mg/day or placebo for 4 weeks. Following a 2-week wash-out phase, the patients were crossedover to receive the other treatment for 4 weeks. Primary efficacy criterion was the intra-individual difference between mean itch intensity (visual analogue scale) at baseline compared with the end of treatment period. Prurigo lesions, pruritus course, quality of life, patient benefits, and safety were secondary parameters. No significant differences were found between aprepitant treatment and placebo for any of the parameters investigated. Under the experimental conditions of the study, aprepitant, 80 mg daily for 4 weeks, did not have an antipruritic effect in patients with chronic prurigo. (DRKS00005594; EudraCT Number: 2013-001601-85).

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Section: Discussionmentioning

confidence: 99%

Aprepitant in Anti-histamine-refractory Chronic Nodular Prurigo: A Multicentre, Randomized, Double-blind, Placebo-controlled, Cross-over, Phase-II trial (APREPRU)

Tsianakas¹,

Zeidler²,

Riepe³

et al. 2019

Acta Derm Venerol

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“…PN has been significantly associated with depression, anxiety, and dissociative experiences, all of which can cause psychogenic pruritus [1,[53][54][55][56][57][58]. This psychogenic pruritus is then thought to lead to PN.…”

Section: Psychiatricmentioning

confidence: 99%

Diagnostic Workup and Evaluation of Patients with Prurigo Nodularis

et al. 2019

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Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized oftentimes by symmetrically distributed, severely pruritic nodules. Currently, the pathophysiology of PN remains to be fully elucidated, but emerging evidence suggests that neuroimmune alterations play principal roles in the pathogenesis of PN. There are several associated etiologic factors thought to be associated with PN, including dermatoses, systemic, infectious, psychiatric, and neurologic conditions. We conducted a systematic literature review to evaluate the clinical presentation, diagnosis, and etiologic factors of PN. In this review, we discuss common differential diagnoses of PN and recommend an evidence-based, standardized diagnostic evaluation for those with suspected PN.

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“…The burden of itch has been described for specific skin diseases such as hand eczema (Boehm et al, 2012), atopic dermatitis (Chrostowska-Plak et al, 2013;Simpson et al, 2018), psoriasis (Chrostowska-Plak et al, 2013;Reich et al, 2016Reich et al, , 2010Zachariae et al, 2012), prurigo nodularis (Brenaut et al, 2019;Konda et al, 2015), and hidradenitis suppurativa (Kaaz et al, 2018); among hemodialysis patients (Suseł et al, 2014;Weiss et al, 2016;Yamamoto et al, 2009); and in chronic itch patients in general (Schneider et al, 2006;Steinke et al, 2018;Stumpf et al, 2015). The cross-aggravation of pruritus and depression was demonstrated to give important implications for the treatment of depression in patients with pruritus (Wang et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Itch and Mental Health in Dermatological Patients across Europe: A Cross-Sectional Study in 13 Countries

Dalgard

Svensson

Halvorsen

et al. 2020

Journal of Investigative Dermatology

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Itch is a highly prevalent and multidimensional symptom. We aimed to analyze the association between itch and mental health in dermatological patients. This multicenter study is observational and cross-sectional and was conducted in dermatological clinics across 13 European countries. A total of 3,530 patients and 1,094 healthy controls were included. Patients were examined clinically. Outcome measures were itch (presence, chronicity, and intensity), the Hospital Anxiety and Depression Scale, EQ-5D visual analogue scale, sociodemographics, suicidal ideation, and stress (negative life events and economic difficulties). Ethical approval was obtained. Results showed significant association between the presence of itch in patients and clinical depression (odds ratio, 1.53; 95% confidence interval, 1.15e2.02), suicidal ideation (odds ratio, 1.27; 95% confidence interval, 1.01e1.60), and economic difficulties (odds ratio, 1.24; 95% confidence interval, 1.10e1.50). The mean score of reported generic health status assessed by the EQ-5D visual analogue scale was 65.9 (standard deviation ¼ 20.1) in patients with itch, compared with 74.7 (standard deviation ¼ 18.0) in patients without itch (P < 0.001) and 74.9 (standard deviation ¼ 15.7) in controls with itch compared with 82.9 (standard deviation ¼ 15.6) in controls without itch (P < 0.001). Itch contributes substantially to the psychological disease burden in dermatological patients, and the management of patients should include access to multidisciplinary care.

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The self‐assessed psychological comorbidities of prurigo in European patients: a multicentre study in 13 countries

Abstract: The psychological comorbidities of prurigo are common, greater than those of other skin diseases, and their impact on quality of life is significant. Thus, it is important to study this condition and to find new treatments.

Cited by 59 publications

References 24 publications

Aprepitant in Anti-histamine-refractory Chronic Nodular Prurigo: A Multicentre, Randomized, Double-blind, Placebo-controlled, Cross-over, Phase-II trial (APREPRU)

Aprepitant in Anti-histamine-refractory Chronic Nodular Prurigo: A Multicentre, Randomized, Double-blind, Placebo-controlled, Cross-over, Phase-II trial (APREPRU)

Diagnostic Workup and Evaluation of Patients with Prurigo Nodularis

Itch and Mental Health in Dermatological Patients across Europe: A Cross-Sectional Study in 13 Countries

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