A critical review of dupilumab for adult patients with prurigo nodularis

Expert Rev Clin Immunol. 2024 Mar;20(3):249-254. doi: 10.1080/1744666X.2023.2268291. Epub 2023 Oct 12.

Abstract

Introduction: Prurigo nodularis (PN) is a chronic inflammatory skin condition that presents with pruritus and hyperkeratotic nodules. These symptoms impact patients' quality of life and mental health. Treating prurigo nodularis is challenging, and many of the available topical and systemic therapies have limited efficacy and a myriad of adverse effects.

Areas covered: In this article, we discuss the use of dupilumab for adult patients with prurigo nodularis. Dupilumab is a biologic that inhibits Th2-mediated inflammation and has been successfully used to treat a variety of dermatologic disorders. Dupilumab has revolutionized the management of PN, with recent clinical trials showing its efficacy in treating both pruritus and prurigo nodules, as well as improving quality of life. It has a favorable safety profile and is well tolerated. Other novel treatments are also currently under investigation for the treatment of PN, with early studies reporting promising results.

Expert opinion: Dupilumab is becoming the drug of choice for the treatment of PN and may also be effective in treating patients with systemic underlying causes of their PN, although more studies are needed to assess this. Trials evaluating the long-term efficacy and durability of dupilumab in PN are also of interest.

Keywords: Dupilumab; itch; prurigo nodularis; pruritus; type 2 inflammation.

Publication types

  • Review

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Humans
  • Prurigo* / diagnosis
  • Prurigo* / drug therapy
  • Prurigo* / etiology
  • Pruritus / drug therapy
  • Pruritus / etiology
  • Quality of Life

Substances

  • dupilumab
  • Antibodies, Monoclonal, Humanized