Effectiveness of Dupilumab for an Elderly Patient with Prurigo Nodularis Who Was Refractory and Contradicted to Traditional Therapy

Liu, Taoming; Bai, Juan; Wang, Su; Ying, Shilong; Li, Sheng; Qiao, Jianjun; Fang, Hong

doi:10.2147/jaa.s300975

Cited by 10 publications

(9 citation statements)

References 11 publications

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“…Our study showed that a signifcant reduction was observed in disease severity as measured by NRS and DLQI scores after four months of treatment, and dupilumab has achieved good efcacy in PN with few adverse reactions and high safety. Te results of this study are similar to previous studies [14,25,26]. It can quickly reduce itching, prevent the appearance of new nodules, and gradually reduce the number of current nodules [14].…”

Section: Discussionsupporting

confidence: 87%

“…Te pathogenesis of PN is largely related to the enhanced infammatory response, and several proinfammatory and pruritic cytokines are elevated in PN lesions, including T2related cytokines such as the interleukins IL-31 and IL-4 [2]. Dupilumab inhibits the type 2 immune response by blocking the IL-4 and IL-13 pathways, which can be used to break the pruritus cycle of PN and achieve the purpose of treatment [25]. In our study, a retrospective observational study of PN was performed.…”

Section: Discussionmentioning

confidence: 99%

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Dupilumab Therapy of Prurigo Nodularis: A Single‐Center, Real‐Life Observational Study

Jing

Yang

Liu

et al. 2023

Dermatologic Therapy

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Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by severe itching accompanied by multiple nodules throughout the body. There is currently no effective drug-targeted treatment for PN. Dupilumab is a fully human monoclonal antibody which can suppress the Th2 inflammatory reaction. We aimed to assess the efficacy and safety of dupilumab in PN. There were 29 PN patients who received dupilumab treatment for four months. Serum total immunoglobulin E (Ig E), eosinophil counts, dermatology life quality index (DLQI), and numeric rating scale (NRS) were assessed on patients before and after treatment. We count the vaccination of novel coronavirus pneumonia (COVID-19) in patients and the impact on PN and treatment measures after vaccination. Plotting was performed using GraphPad Prism8, and the statistical analysis was performed using PASW Statistics18. The eosinophil counts in patients higher decreased to normal, and the Ig E levels gradually decreased and tended to normal levels after receiving dupilumab injection. The average DLQI score at the baseline was 23.93 ± 0.66 and decreased to 11.66 ± 0.55 ( P < 0.01 ) and 1.83 ± 0.22 ( P < 0.01 ) at 1-month and 6-monthfollow-up of treatment, respectively. The average NRS score at the baseline was 9.79 ± 0.08 and decreased to 3.52 ± 0.23 ( P < 0.01 ) and 0.31 ± 0.15 ( P < 0.01 ) at the 1-month and 6-monthfollow-up of treatment, respectively. Our study shows that dupilumab has achieved good efficacy in PN with few adverse reactions and high safety. We can recommend that patients follow the advice of specialists to be vaccinated and under the condition of stable disease, separated from dupilumab treatment for one week.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Dupilumab Therapy of Prurigo Nodularis: A Single‐Center, Real‐Life Observational Study

Jing

Yang

Liu

et al. 2023

Dermatologic Therapy

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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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“…Beyond dermatology, dupilumab is also effective and approved for moderate-to-severe asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP) [ 6 ] and eosinophilic esophagitis. In addition, efficacy of dupilumab in prurigo nodularis (PN) and other forms of chronic prurigo was previously shown in several reports [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. The phase 3 clinical trials LIBERTY-PN PRIME and PRIME2 showed significantly reduced itch, amelioration of skin lesions, sleep, pain and quality of life compared to placebo treatment in a total of 153 treated patients (NCT04202679, NCT04183335).…”

Section: Introductionmentioning

confidence: 99%

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

et al. 2023

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Dupilumab was first approved for the treatment of atopic dermatitis (AD) and blocks the signaling of interleukin (IL)-4 and -13. Several other chronic skin conditions share mechanistic overlaps with AD in their pathophysiology, i.e., are linked to type 2 inflammation. Most recently, dupilumab was approved by the U.S. Food and Drug Administration for prurigo nodularis (PN). Given its relatively good safety profile, effective off-label use of dupilumab has been reported for a multitude of dermatologic diseases and several clinical trials for dermatologic skin conditions are currently ongoing. We conducted a systematic review of applications of dupilumab in dermatology other than AD and PN by searching the databases PubMed/Medline, Scopus, Web of Science and Cochrane Library as well as the clinical trial registry ClinicalTrials.gov. We found several reports for effective treatment of bullous autoimmune diseases, eczema, prurigo, alopecia areata, chronic spontaneous urticaria, Netherton syndrome and a variety of other chronic inflammatory skin diseases.

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Effectiveness of Dupilumab for an Elderly Patient with Prurigo Nodularis Who Was Refractory and Contradicted to Traditional Therapy

Cited by 10 publications

References 11 publications

Dupilumab Therapy of Prurigo Nodularis: A Single‐Center, Real‐Life Observational Study

Dupilumab Therapy of Prurigo Nodularis: A Single‐Center, Real‐Life Observational Study

Dupilumab for the treatment of prurigo nodularis: A systematic review

Dupilumab in Inflammatory Skin Diseases: A Systematic Review

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