Serlopitant for psoriatic pruritus: A phase 2 randomized, double-blind, placebo-controlled clinical trial

J Am Acad Dermatol. 2020 Jun;82(6):1314-1320. doi: 10.1016/j.jaad.2020.01.056. Epub 2020 Jan 30.

Abstract

Background: Pruritus, a common symptom of psoriasis, negatively affects quality of life; however, treatment of lesional skin does not consistently alleviate psoriatic itch.

Objective: To examine the effects of serlopitant, an oral, once-daily neurokinin 1 receptor antagonist, for treatment of psoriatic pruritus in a phase 2, randomized clinical trial (NCT03343639).

Methods: Patients (n = 204) were randomized to receive serlopitant, 5 mg, or placebo daily for 8 weeks. Eligible adult patients had plaque psoriasis for ≥6 months, plaques covering ≤10% of body surface area, pruritus for ≥4 weeks, and Worst Itch Numeric Rating Scale (WI-NRS) score ≥7 at the initial screening.

Results: Participants (54.2% women) had a mean age of 47.5 years and 85.2% were white. Mean baseline WI-NRS scores were 8.3 for serlopitant and 8.1 for placebo. The WI-NRS 4-point response rate at 8 weeks (primary end point) was 33.3% for serlopitant vs 21.1% for placebo (P = .028); at 4 weeks the rates were 20.8% for serlopitant vs 11.5% for placebo (P = .039). Treatment-related adverse events were reported for 4.9% of serlopitant-treated and 4.0% of placebo-treated patients.

Limitations: This was a phase 2 study with a small study population. Patients with severe psoriasis were excluded.

Conclusion: Serlopitant significantly reduced pruritus associated with mild to moderate psoriasis, supporting continued development of serlopitant for this patient population.

Keywords: clinical trial; neurokinin 1 receptor (NK(1)R); pruritus; psoriasis; serlopitant; substance P.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Diarrhea / chemically induced
  • Female
  • Headache / chemically induced
  • Humans
  • Isoindoles / adverse effects
  • Isoindoles / therapeutic use*
  • Male
  • Middle Aged
  • Nasopharyngitis / chemically induced
  • Neurokinin-1 Receptor Antagonists / adverse effects
  • Neurokinin-1 Receptor Antagonists / therapeutic use*
  • Pruritus / drug therapy*
  • Pruritus / etiology
  • Psoriasis / complications*
  • Severity of Illness Index

Substances

  • Isoindoles
  • Neurokinin-1 Receptor Antagonists
  • serlopitant

Associated data

  • ClinicalTrials.gov/NCT03343639