Emerging drugs for the treatment of pruritus

Ständer, Sonja; Weißhaar, Elke; Raap, Ulrike

doi:10.1517/14728214.2015.1051964

Cited by 22 publications

(7 citation statements)

References 20 publications

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“…[12][13][14] One hypothesis as to why patients with HIV are at an increased risk of pruritic conditions is the possibility that these patients may still have increased levels of certain T helper type 2 cytokines, despite ART treatment, which may promote a pruritic response. 15,16 Limitations of this study include inability to determine causality and detection bias in patients with HIV infection, who may have more thorough and frequent clinician visits and physical examinations than the general population. Additionally, because these data were collected from the entire hospital system, patient dermatologic conditions may not have been well documented unless the patient was seen by a dermatologist.…”

Section: Discussionmentioning

confidence: 99%

Racial differences in dermatologic conditions associated with HIV: A cross-sectional study of 4679 patients in an urban tertiary care center

Bender

Tang

Khanna

et al. 2020

Journal of the American Academy of Dermatology

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Background: Because of reduced mortality, patients with HIV are living longer and presenting with chronic diseases. Little is known about racial differences in dermatologic conditions associated with HIV infection. Objective: This study examines associated dermatologic conditions in a large population of patients with HIV at a tertiary care center with a diverse patient population. Methods: Cross-sectional study of patients with HIV seen between July 14, 2013, and July 14, 2018, in a tertiary health care system. The burden of HIV-related dermatologic conditions was collected by using medical records. Patients with HIV were compared with control individuals of the same race, and significance was assessed using the chi-square test. A Bonferroni correction was performed to control for multiple hypothesis testing. Results: The study population (N = 4679) was 64.7% male and 69% African American, with 88.7% of patients receiving antiretroviral therapy. African American patients with HIV had a greater risk of oral hairy leukoplakia (odds ratio [OR], 64.49), herpes zoster (OR, 9.27), prurigo nodularis (OR, 8.80), and squamous cell carcinoma (OR, 5.72). Limitations: Our data describe patients seen by 1 health care system. Conclusions: African American patients with HIV may be at increased risk for pruritic disorders compared with race-matched control individuals and white patients with HIV.

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Section: Discussionmentioning

confidence: 99%

Racial differences in dermatologic conditions associated with HIV: A cross-sectional study of 4679 patients in an urban tertiary care center

Bender

Tang

Khanna

et al. 2020

Journal of the American Academy of Dermatology

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“…In dermatological diseases, IL-31 is of particular interest in terms of itch and inflammation as well as impaired skin-barrier function arising from IL-31-induced tissue remodeling (13, 14). The cytokine was not only found to induce severe pruritus in mice, where levels of IL-31 correlated with scratching behavior, but a NC/Nga mouse model of atopic dermatitis demonstrated the potential therapeutic benefit of blocking anti-IL-31 antibodies (1, 15, 16).…”

Section: General Properties Of Il-31 In Skin Diseasesmentioning

confidence: 99%

Role of the Pruritic Cytokine IL-31 in Autoimmune Skin Diseases

2019

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Many autoimmune skin diseases, such as bullous pemphigoid (BP), psoriasis and certain types of chronic urticaria, are associated with intensive pruritus. While histamine and neuropeptides have previously been ascribed to play a role in itch that accompanies these diseases, recent evidence suggests that the pruritogenic cytokine interleukin (IL)-31 is a major driver of pruritic responses. IL-31 was originally shown to be produced by activated helper T cells, particularly Th2 cells, mast cells, macrophages and dendritic cells. However, more recent evidence demonstrated that eosinophils are a major source of this cytokine too, particularly in bullous pemphigoid. Basophils have also been shown to express the cytokine which, through autocrine action, strongly supports the production of other Th2-type cytokines from these cells. These investigations suggest that the dynamic recruitment of eosinophils and basophils in some autoimmune skin diseases could play an important role in the severity of IL-31-mediated itch. Furthermore, these studies suggest that IL-31, in addition to its pruritic actions, also has potential immunomodulatory roles in terms of supporting Th2-type immunity, which often underpins IgE-associated autoimmune diseases (such as bullous pemphigoid and urticaria) as well as allergies. While the role of IL-31 in psoriasis remains to be clarified, current evidence shows that this cytokine plays a major role in BP, chronic spontaneous urticaria and dermatomyositis. This suggests potential use of IL-31 receptor-blocking therapeutic approaches (e.g., Nemolizumab) for the treatment of IL-31-associated disorders.

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“…Many novel mechanisms of pruritus have been identified recently, allowing experts to establish therapy targets. Although many randomized controlled trials (RCT) have been initiated (5), it is difficult to assess pruritus because it is a subjective symptom (6). The study end-points, usually the determination of the course of the itch and quality of life, can be assessed by validated patient-reported outcomes (PRO).…”

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confidence: 99%

Gernart

Tsianakas²,

Zeidler³

et al. 2017

Acta Derm Venerol

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Performing a reliable assessment of chronic pruritus remains a challenge. Electronic diaries are often used, but many of the scales have not been validated. ItchApp© was developed for Android smartphones in order to address this lack. A total of 40 subjects with chronic pruritus completed questionnaires both on paper and with ItchApp© (verbal rating scale, numerical rating scale, dynamic pruritus score) in order to validate the software application. Strong correlations were found for test-retest reliability (intraclass correlation coefficient: 0.865-0.977) and convergent validity (Spearman's r: 0.442-0.924). A feasibility questionnaire for ItchApp© revealed a high level of user friendliness and compliance. This was confirmed in a randomized controlled trial with 68 subjects, for which the clinically important difference in the numerical rating scale values for ItchApp© was calculated (2.61 points). In summary, ItchApp© is a recently developed eDiary that can provide experts with a reliable evaluation of patients with chronic pruritus. It will be made available for future clinical trials.

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Emerging drugs for the treatment of pruritus

Cited by 22 publications

References 20 publications

Racial differences in dermatologic conditions associated with HIV: A cross-sectional study of 4679 patients in an urban tertiary care center

Racial differences in dermatologic conditions associated with HIV: A cross-sectional study of 4679 patients in an urban tertiary care center

Role of the Pruritic Cytokine IL-31 in Autoimmune Skin Diseases

ItchApp©: An App-based eDiary for Assessment of Chronic Pruritus in Clinical Trials

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