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Dupilumab for Chronic Prurigo: Case Series on Effectiveness, Safety, and Quality of Life


Richter, Clara; Hafner, Jürg; Schuermann, Manuel; Tanadini, Matteo; Trisconi, Nisia; Schmid-Grendelmeier, Peter; Kündig, Thomas; Nägeli, Mirjam; Brüggen, Marie-Charlotte; Guillet, Carole (2023). Dupilumab for Chronic Prurigo: Case Series on Effectiveness, Safety, and Quality of Life. Dermatology, 239(5):811-817.

Abstract

Background: Chronic prurigo (CPG) is a pruritic skin disease, characterized by an itch-scratch cycle and scarring. It reduces patients’ quality of life (QoL). Dupilumab is a monoclonal human IgG antibody that inhibits signaling of the interleukin 4 (IL-4) and interleukin 13 (IL-13) pathways through blockade of the IL-4 receptor. Patients with CPG who receive dupilumab often report great improvement in itch and overall QoL. We therefore reviewed our experience in order to follow up on QoL, safety, and treatment response in patients with CPG who received dupilumab.
Methods: We conducted a real-world retrospective single-center case series. Outcomes were assessed by phone interviews and photographs using validated questionnaires and scores. Demographic data were obtained from the hospital files. Follow-up was up to 2 years. We assessed QoL with the Dermatology Life Quality Index (DLQI) and the Itchy quality of life questionnaire (ItchyQoL). Numerical Rating Scale (NRS) was used to assess itch. Prurigo lesions were documented with the Prurigo activity and severity score (PAS).
Results: Ten patients were included in this study. Results were reported up to 2 years after treatment with dupilumab. The response variables for DLQI, ItchyQoL, NRS, and PAS analyses showed a statistically significant decrease over time (DLQI: p ≤ 0.0001 [−0.84; −1.27], ItchyQoL: p ≤ 0.0001 [−9.89; −18.69], NRS maximum and average: p ≤ 0.0001 [−0.52; −0.86] and p ≤ 0.0001 [−0.55; −0.94], and PAS number of lesions: p = 0.0005 [−1.70; −5.28]). The percent decrease after 1 year of treatment (this estimate is based on model estimates) ranges from −42% to −82%. Four (40%) patients reported mild side effects. No serious side effects were reported.
Conclusion: Dupilumab treatment of CGP for up to 2 years is associated with improved QoL and less itching.

Abstract

Background: Chronic prurigo (CPG) is a pruritic skin disease, characterized by an itch-scratch cycle and scarring. It reduces patients’ quality of life (QoL). Dupilumab is a monoclonal human IgG antibody that inhibits signaling of the interleukin 4 (IL-4) and interleukin 13 (IL-13) pathways through blockade of the IL-4 receptor. Patients with CPG who receive dupilumab often report great improvement in itch and overall QoL. We therefore reviewed our experience in order to follow up on QoL, safety, and treatment response in patients with CPG who received dupilumab.
Methods: We conducted a real-world retrospective single-center case series. Outcomes were assessed by phone interviews and photographs using validated questionnaires and scores. Demographic data were obtained from the hospital files. Follow-up was up to 2 years. We assessed QoL with the Dermatology Life Quality Index (DLQI) and the Itchy quality of life questionnaire (ItchyQoL). Numerical Rating Scale (NRS) was used to assess itch. Prurigo lesions were documented with the Prurigo activity and severity score (PAS).
Results: Ten patients were included in this study. Results were reported up to 2 years after treatment with dupilumab. The response variables for DLQI, ItchyQoL, NRS, and PAS analyses showed a statistically significant decrease over time (DLQI: p ≤ 0.0001 [−0.84; −1.27], ItchyQoL: p ≤ 0.0001 [−9.89; −18.69], NRS maximum and average: p ≤ 0.0001 [−0.52; −0.86] and p ≤ 0.0001 [−0.55; −0.94], and PAS number of lesions: p = 0.0005 [−1.70; −5.28]). The percent decrease after 1 year of treatment (this estimate is based on model estimates) ranges from −42% to −82%. Four (40%) patients reported mild side effects. No serious side effects were reported.
Conclusion: Dupilumab treatment of CGP for up to 2 years is associated with improved QoL and less itching.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Dermatology
Uncontrolled Keywords:Dermatology
Language:English
Date:October 2023
Deposited On:15 Dec 2023 09:19
Last Modified:29 Jun 2024 01:41
Publisher:Karger
ISSN:1018-8665
OA Status:Hybrid
Publisher DOI:https://doi.org/10.1159/000531708
PubMed ID:37369187
  • Content: Published Version
  • Language: English
  • Licence: Creative Commons: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)