Tratamiento del prurigo nodular con DupilumabNuestra experiencia

  1. Aramburu-González, Aida 1
  2. Julià-Manresa, Marc 2
  3. Izu-Belloso, Rosa 2
  4. Ratón-Nieto, Juan-Antonio 1
  1. 1 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Ezkerraldea-Enkarterri-Cruces. Hospital Universitario Cruces. Servicio de Dermatología. Bilbao, España
  2. 2 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Bilbao-Basurto. Hospital Universitario Basurto. Servicio de Dermatología. Bilbao, España
Journal:
Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

ISSN: 0304-4858,  2173-2302

Year of publication: 2024

Volume: 121

Issue: 1

Pages: 1-9

Type: Article

DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

Abstract

Introduction: Prurigo nodularis (PN) is a pruritic and debilitating skin disease characterized by hyperkeratotic cutaneous nodules. It is a neurodermatitis with an unmet therapeutic need that can significantly impact the quality of life of patients.Objectives: The aim of the study is to evaluate the efficacy of dupilumab in adults with PN refractory to other systemic treatments.Material and methods: A retrospective study was performed in adult patients diagnosed with PN at Basurto University Hospital and Cruces University Hospital who started treatment with dupilumab from June 2020 to November 2021 with a follow-up of 24 weeks. The severity of PN was assessed using the BSA (body surface area scale), the IGA (investigator's global assessment scale), the NRS (numerical rating scale of pruritus), the insomnia scale and the DLQI (Dermatology quality of life index).Results: Six patients with PN (100% female; mean age= 52 years; range 44- 66 years) were treated with dupilumab. Significant improvement in pruritus scale, insomnia, quality of life index, body surface area affected and investigator's global assessment scale was observed in all cases after treatment with dupilumab.Conclusions: Dupilumab may be an effective and safe treatment option for chronic PN refractory to conventional treatments.

Bibliographic References

  • Qureshi AA, Abate LE, Yosipovitch G, Friedman AJ: A systematic review of evidence-based treatments for prurigo nodularis. J Am Acad Dermatol.2019;80:756-764.http://dx.doi.org/10.1016/j.jaad.2018.09.020.
  • Kowalski EH, Kneiber D, Valdebran M, Patel U, Amber KT. Treatment-resistant prurigo nodularis: challenges and solutions. Clin Cosmet Investig Dermatol. 2019;12:163-172. http://dx.doi.org/10.2147/CCID.S188070.
  • Huang AH, Williams KA, Kwatra SG. Prurigo nodularis: Epidemiology and clinical features. J Am Acad Dermatol. 2020;83(6):1559-1565. http://dx.doi.org/10.1016/j.jaad.2020.04.183.
  • Williams KA, Huang AH, Belzberg M, Kwatra SG. Prurigo nodularis: Pathogenesis and management. J Am Acad Dermatol. 2020;83(6):1567-1575.http://dx.doi.org/10.1016/j.jaad.2020.04.182.
  • Mollanazar NK, Elgash M, Weaver L, Valdes-Rodriguez R, Hsu S. Reduced Itch Associated With Dupilumab Treatment In 4 Patients With Prurigo Nodularis. JAMA Dermatol. 2019;155(1):121-122.http://dx.doi.org/10.1001/jamadermatol.2018.3906.
  • Napolitano M, Fabbrocini G, Scalvenzi M, Nisticò SP, Dastoli S, Patruno C: Effectiveness of dupilumab for the treatment of generalized prurigo nodularis phenotype of adult atopic dermatitis.2020;81-84. http://dx.doi.org/10.1097/DER.0000000000000517.
  • Beck KM, Yang EJ, Sekhon S, Bhutani T, Liao W. Dupilumab Treatment for Generalized Prurigo Nodularis. JAMA Dermatol. 2019;155(1):118-120.http://dx.doi.org/10.1001/jamadermatol.2018.3912.
  • Calugareanu A, Jachiet M, Lepelletier C, De Masson A, Rybojad M, Bagot M, Bouaziz JD. Dramatic improvement of generalized prurigo nodularis with dupilumab. J Eur Acad Dermatol Venereol. 2019;33(8):e303-e304. http://dx.doi.org/10.1111/jdv.15584.
  • Husein-ElAhmed H, Steinhoff M. Dupilumab in prurigo nodularis: a systematic review of current evidence and analysis of predictive factors to response. J Dermatolog Treat. 2020:1-7. http://dx.doi.org/10.1080/09546634.2020.1853024.
  • Ferrucci S, Tavecchio S, Berti E, Angileri L. Dupilumab and prurigo nodularis-like phenotype in atopic dermatitis: our experience of efficacy. J Dermatolog Treat. 2021;32(4):453-454. http://dx.doi.org/10.1080/09546634.2019.1659479.
  • Kovács B, Rose E, Kuznik N, Shimanovich I, Zillikens D, Ludwig RJ, Thaçi D. Dupilumab for treatment- refractory prurigo nodularis. J Dtsch Dermatol Ges. 2020;18(6):618-624. http://dx.doi.org/10.1111/ddg.14107.
  • Romano C. Safety and Effectiveness of Dupilumab in Prurigo Nodularis. J Investig Allergol Clin Immunol. 2020:0. http://dx.doi.org/10.18176/jiaci.0550.
  • Fachler T, Maria Faitataziadou S, Molho-Pessach V. Dupilumab for pediatric prurigo nodularis: A case report. Pediatr Dermatol. 2021;38(1):334-335. http://dx.doi.org/10.1111/pde.14464.
  • Georgakopoulos JR, Croitoru D, Felfeli T, Alhusayen R, Lansang P, Shear NH, Yeung J, Walsh S. Longterm Dupilumab Treatment for Chronic Refractory Generalized Prurigo Nodularis: A Retrospective Cohort Study. J Am Acad Dermatol. 2021:S0190-9622(21)00363-7.http://dx.doi.org/10.1016/j.jaad.2021.02.038.
  • Liu T, Bai J, Wang S, Ying S, Li S, Qiao J, Fang H. Effectiveness of Dupilumab for an Elderly Patient with Prurigo Nodularis Who Was Refractory and Contradicted to Traditional Therapy. J Asthma Allergy. 2021;14:175-178. http://dx.doi.org/10.2147/JAA.S300975.
  • Lim VM, Maranda EL, Patel V, Simmons BJ, Jimenez JJ. A Review of the Efficacy of Thalidomide and Lenalidomide in the Treatment of Refractory Prurigo Nodularis. Dermatol Ther (Heidelb). 2016 Sep;6(3):397-411. http://dx.doi.org/10.1007/s13555-016-0122-9.
  • Lan CC, Lin CL, Wu CS, Chai CY, Chen WT, Chen GS. Treatment of idiopathic prurigo nodularis in Taiwanese patients with low-dose thalidomide. J Dermatol. 2007 Apr;34(4):237-42. http://dx.doi.org/10.1111/j.1346-8138.2007.00260.x.
  • Taefehnorooz H, Truchetet F, Barbaud A, Schmutz JL, Bursztejn AC. Efficacy of thalidomide in the treatment of prurigo nodularis. Acta Derm Venereol. 2011 May;91(3):344-5. http://dx.doi.org/10.2340/00015555-0997.
  • Doherty SD, Hsu S. A case series of 48 patients treated with thalidomide. J Drugs Dermatol. 2008 Aug;7(8):769-73.
Data source: Dialnet