Dupilumab improves clinical manifestations, symptoms, and quality of life in adult patients with chronic nodular prurigo

• DOI: 10.1016/j.jaad.2020.03.049
• Publication Date: 2020-03-28T00:08:47Z
• Authors: Andrea Chiricozzi; Martina Maurelli; Niccolò Gori; Giuseppe Argenziano; Clara De Simone; Giulia Calabrese; Giampiero Girolomoni; Ketty Peris
• Keywords: Dupilumab; Tolerability; Prurigo; Refractory (planetary science); Prurigo nodularis

Chronic nodular prurigo (CNPG) is a multifactorial skin disease characterized by itchy papules and nodules, usually resistant to standard treatment and associated with markedly impaired quality of life.To describe dupilumab effectiveness and tolerability in treating adult patients with CNPG refractory to both topical and systemic therapies.Retrospective, multicenter study including adult patients affected by CNPG, who were treated with dupilumab for at least 16 weeks.Twenty-seven CNPG patients showed clinical improvement in terms of skin lesions, itch, sleeplessness, and quality of life. A consistent proportion of patients (24/27; 88.9%) had at least 16-week continuous treatment and achieved Investigator Global Assessment score 1 (11/24; 45.8%). An increased number of patients achieved at least a 2-grade reduction in Investigator Global Assessment score (19/24; 79.2%). Numeric rating scale values for itch and sleeplessness decreased from 8.9 to 2.7 and from 8.2 to 1.7, respectively (P < .001) after 16-week therapy. Ten patients achieved 36 weeks of continuous treatment while maintaining clinical efficacy.Major limitations included lack of validated assessment tools at the initial data collection, a limited cohort of treated patients, and a short-term observation period.Dupilumab was proven effective in reducing itch and improving CNPG skin lesions.