Humanistic burden of chronic pruritus in patients with inflammatory dermatoses: Results of the European Academy of Dermatology and Venereology Network on Assessment of Severity and Burden of Pruritus (PruNet) cross-sectional trial

Steinke, Sabine; Zeidler, Claudia; Riepe, Claudia; Bruland, Philipp; Soto-Rey, Iñaki; Storck, Michael; Augustin, Matthias; Bobko, Svetlana; Garcovich, Simone; Legat, Franz J.; Lvov, A. N.; Miséry, Laurent; Osada, Nani; Reich, Adam; Şavk, Ekin; Serra‐Baldrich, E.; Streit, Markus; Szepietowski, Jacek C.; Weger, Wolfgang; Dugas, Martin; Ständer, Sonja

doi:10.1016/j.jaad.2018.04.044

Cited by 66 publications

(87 citation statements)

References 38 publications

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“…Interestingly, these differences, although in part likely due to different pathophysiology of these conditions, may also be explained by the difference in burden caused by the pruritus. A recent study examining the burden of pruritus amongst inflammatory dermatoses found that patients with PN were significantly more bothered by evening and nighttime pruritus and reported more significant impairment in quality of life as compared to patients with psoriasis and AD, despite the association of AD and PN [25,26].…”

Section: Discussionmentioning

confidence: 99%

Association between Prurigo Nodularis and Etiologies of Peripheral Neuropathy: Suggesting a Role for Neural Dysregulation in Pathogenesis

et al. 2020

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Background: Prurigo nodularis (PN) is an intensely pruritic skin condition of considerable morbidity. However, the pathogenesis of PN and its association with underlying neuropathy is unclear. Objective: We sought to investigate the association between PN and etiologies of peripheral neuropathy. Methods: A cross-sectional analysis of adult patients (≥18-year-old) with PN, AD, and Psoriasis at the Johns Hopkins Health System over a six-year period (January 2013–January 2019) was performed. The strength of association with etiologies of peripheral neuropathy were compared to a control cohort of individuals without PN, as well as those with AD or psoriasis. Results: A total of 1122 patients with PN were compared to 10,390 AD patients, 15,056 patients with psoriasis, and a control cohort of 4,949,017 individuals without PN, with respect to 25 comorbidities associated with peripheral neuropathies. Limitations: Comparisons between peripheral neuropathies and PN represent associations but are not causal relationships. Conclusion: Prurigo nodularis is strongly associated with peripheral neuropathies, suggesting a role for neural dysregulation in pathogenesis.

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Section: Discussionmentioning

confidence: 99%

Association between Prurigo Nodularis and Etiologies of Peripheral Neuropathy: Suggesting a Role for Neural Dysregulation in Pathogenesis

et al. 2020

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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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“…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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Humanistic burden of chronic pruritus in patients with inflammatory dermatoses: Results of the European Academy of Dermatology and Venereology Network on Assessment of Severity and Burden of Pruritus (PruNet) cross-sectional trial

Cited by 66 publications

References 38 publications

Association between Prurigo Nodularis and Etiologies of Peripheral Neuropathy: Suggesting a Role for Neural Dysregulation in Pathogenesis

Association between Prurigo Nodularis and Etiologies of Peripheral Neuropathy: Suggesting a Role for Neural Dysregulation in Pathogenesis

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

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

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