Abstract
Background
Prurigo nodularis (PN) is a neuroimmunological skin disease. Severe itching is the most challenging symptom which affects patients’ quality of life. T helper 2-derived cytokines, such as interleukin-31 and oncostatin M (OSM), play a crucial role in PN pathogenesis. Nemolizumab and vixarelimab are two biologics acting as IL-31 inhibitors. Vixarelimab also suppresses the OSM activity. This systematic review evaluates the efficacy and safety of nemolizumab and vixarelimab in PN management.
Methods
A systematic search was conducted in PubMed/Medline, Ovid Embase, and Web of Science up to September 17th, 2023. Clinical trials and cohort studies published in English were included.
Results
Among a total of 96 relevant records, five were included. The results of four studies with 452 patients using nemolizumab showed that a significantly higher percentage of patients treated with nemolizumab demonstrated a reduction in peak pruritus numerical rating scale (PP-NRS) and investigator’s global assessment along with improved sleep disturbance (SD) and quality of life than the placebo group. Moreover, one study administered vixarelimab to 49 PN patients, and their finding illustrated a higher rate of subjects who received vixarelimab experienced ≥ 4-point diminution in worst itch NRS, visual analog scale, healing of representative lesions, and SD quality compared to the placebo group.
Conclusions
IL-31 inhibitors suggest distinct advantages in improving pruritus, sleep quality, and overall quality of life in subjects with moderate-to-severe PN. Further clinical studies are recommended to compare the effectiveness of these biologics to other therapeutic choices.
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Data availability
All data produced in the present study are available upon reasonable request to the corresponding author.
Abbreviations
- AD:
-
Atopic dermatitis
- CGPR:
-
Calcitonin-gene related peptide
- DLQI:
-
Dermatology life quality index
- Gp130:
-
Glycoprotein 130
- IGA:
-
Investigator’s global assessment
- IL:
-
Interleukin
- JAK:
-
Janus kinase
- LIF:
-
Leukemia inhibitor factor
- NGF:
-
Nerve growth factor
- NRS:
-
Numerical rating scale
- OSM:
-
Oncostatin M
- PN:
-
Prurigo nodularis
- PP:
-
Peak pruritus
- SD:
-
Sleep disturbance
- SP:
-
Substance P
- Th:
-
T helper
- VAS:
-
Visual analog scale;
- VEGF:
-
Vascular endothelial growth factor;
- WI:
-
Worts itch
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Equal contributions to the current study are MaN and NH in the design, conceptualization, and revision of the final version of the manuscript. YG and AH in database search, screening publications, data extraction, literature review, and manuscript drafting. AH-H in data extraction, designing figures of study, and revising the final version of the manuscript. SaH, FJ, MnN, and PT are critically revising the final version of the manuscript; NnN in design, supervision, and revising the manuscript critically for the importance of intellectual content. All authors have read and approved the final version to be published and agreed to be accountable for all aspects of the work. All authors agreed on the order in which their names are listed in the manuscript.
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Nilforoushzadeh, M.A., Heidari, N., Ghane, Y. et al. A systematic review of interleukin-31 inhibitors in the treatment of prurigo nodularis. Inflammopharmacol 32, 991–1003 (2024). https://doi.org/10.1007/s10787-024-01436-9
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DOI: https://doi.org/10.1007/s10787-024-01436-9