Dupilumab for treatment‐refractory prurigo nodularis

Kovács, Bálint; Rose, Ellen; Kuznik, Nadine; Shimanovich, Iakov; Zillikens, Detlef; Ludwig, Ralf J.; Thaçi, Diamant

doi:10.1111/ddg.14107

Cited by 18 publications

(17 citation statements)

References 14 publications

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“…Thus, 25 articles were included in the analysis as depicted in the search flow chart (Fig. 1), counting a total of 153 patients 21–45 . Demographic and clinical data of CP patients are summarized in Table 1, and those of CIP patients are summarized in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of dupilumab in chronic prurigo and chronic idiopathic pruritus: a systematic review of current evidence and analysis of response predictors

Gael

Adam²,

Bursztejn

2022

Acad Dermatol Venereol

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Dupilumab has demonstrated a great reduction in chronic pruritus that is the hallmark of atopic dermatitis (AD). Underscoring relevant pathogenesis similarities emerging from AD, chronic idiopathic pruritus (CIP) and chronic prurigo (CP), several authors suggested the beneficial role of dupilumab in these conditions. The evidence on this subject is limited with no precise data available. In this study, we carried out a systematic literature review in order to evaluate the efficacy of dupilumab on both pruritus and skin manifestations in the two largest retrospective cohorts of patients with CP and CIP and tried to identify potential response predictors. Electronic searches were conducted on 4 databases. Our primary outcome was the improvement in pruritus measured by a reduction in the patient's reported numerical rating scale of itch (NRSI) by >4. Secondary outcomes included the proportion of patients with a complete response at the end of treatment, reduction in the number of lesions by the Investigator Global Assessment (IGA), improvement in numerical rating scale of sleep (NRSS), improvement in quality of life measured by the Dermatology Life Quality Index (DLQI), time until patient perceived any improvement (Time-First) and time until the patient-reported absence of pruritus (Time-Final). Descriptive statistics were calculated for each demographic and clinical variable. Univariate logistic regression analyses were conducted to explore the association between response to dupilumab and potential predictive factors. We included 25 articles in the analysis, counting a total of 153 patients. Based on CP patients' cohort (n = 132), the mean NRSI at baseline was 8.79 AE 0.86 and the NRSI final was 2.32 AE 1.27. The mean time to first improvement was 5.18 AE 3.13 weeks, while the time to complete improvement of pruritus (Time-final) was 13.6 AE 12.0 weeks. Ninety patients out of 109 (83%) noticed an improvement in pruritus before 4 weeks of dupilumab therapy. At the end of treatment, 18 patients out of 126 (14%) had a complete remission of pruritus and 110 patients out of 123 (89%) had a reduction of NRSI >4. The reduction in NRSI was significantly greater in patients improving before 4 weeks of treatment (6.57 AE 1.71) compared with patients improving in more than 4 weeks (5.49 AE 1.39, P < 0.001). Patients with history of AD and those who have been previously treated with cyclosporine or methotrexate had a significantly lower reduction in NRSI (e.g. 6.05 AE 1.34 vs. 7.08 AE 1.90, P < 0.01 for nonassociated AD patients). Based on CIP patient's cohort (n = 21), the mean NRSI at baseline was 8.33 AE 0.80 and the NRSI final was 0.95 AE 0.59. The mean time to first improvement was 2 AE 0 weeks, while the time to complete improvement (Time-final) was 14.6 AE 10 weeks. At the end of treatment, 3 patients out of 21 (14%) had a complete remission of pruritus and 100% of patients had a reduction of NRSI >4. No serious treatment-emergent adverse events were reported. The most common adverse event was mild conjunctivitis (13 c...

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Section: Resultsmentioning

confidence: 99%

Efficacy of dupilumab in chronic prurigo and chronic idiopathic pruritus: a systematic review of current evidence and analysis of response predictors

Gael

Adam²,

Bursztejn

2022

Acad Dermatol Venereol

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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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“…The other 13 articles were excluded when they were further studied, leaving behind only 24 articles that fulfilled the selection criteria and were included in the study (Figure 1). The 24 publications included only 1 prospective study (11), 5 retrospective studies (12-16), 5 case series (17-21), and 13 case reports (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34).…”

Section: Statistical Analysesmentioning

confidence: 99%

Dupilumab for the treatment of prurigo nodularis: A systematic review

Cao

Jiang

et al. 2023

Front. Immunol.

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BackgroundConventional treatment techniques have limited efficacy and more side effects in the treatment of prurigo nodularis. The better alternative treatment option for better outcomes of the disease is dupilumab.ObjectiveThe objective of this study was to systematically review dupilumab-related treatment outcomes in prurigo nodularis.MethodsSeveral databases like Embase, PubMed, Web of Science, and Cochrane library were searched for data acquisition on October 8, 2022. Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, 24 publications were included in this study.ResultsAfter 4,12,16 and more than 16 weeks of dupilumab treatment, 8.3% (n=5/60), 34.4% (n=11/32), 3.6% (n=2/56), and 45.3% (n=29/64) of patients had complete remission, respectively. In addition, 85.0% (n=51/60), 59.4% (n=19/32), 83.9% (n=47/56), and 43.8% (n=28/64) had partial remission, respectively. Moreover, 6.7% (n=4/60), 6.3% (n=2/32), 12.5% (n=7/56), and 10.9% (n=7/64) showed no remission, respectively, and significant reduction of numeric rating scale itch intensity (from 9.0 to 4.9, 2.1, 2.8, 0.9) was attained. There were no serious adverse events observed during treatment, but the most common event observed was conjunctivitis (12.6%, n=15/119).ConclusionsDupilumab has definite effectiveness and safety in prurigo nodularis treatment.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier (CRD42022365802).

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Dupilumab for treatment‐refractory prurigo nodularis

Cited by 18 publications

References 14 publications

Efficacy of dupilumab in chronic prurigo and chronic idiopathic pruritus: a systematic review of current evidence and analysis of response predictors

Efficacy of dupilumab in chronic prurigo and chronic idiopathic pruritus: a systematic review of current evidence and analysis of response predictors

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

Dupilumab for the treatment of prurigo nodularis: A systematic review

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