What are the effects of nemolizumab treatment in prurigo nodularis patients?
Clinical Applications
Dr. Schwarzenberger is the former physician editor of DermWorld. She interviews the author of a recent study each month.
By Kathryn Schwarzenberger, MD, FAAD, July 1, 2024
In this month’s Clinical Applications column, DermWorld Physician Editor Kathryn Schwarzenberger, MD, FAAD, talks with Shawn G. Kwatra, MD, FAAD, from the University of Maryland, about his NEJM paper ‘Phase 3 trial of nemolizumab in patients with prurigo nodularis.’
DermWorld: You and your colleagues recently published results of a phase 3 trial of nemolizumab in patients with prurigo nodularis. Can you tell us about nemolizumab and why it was chosen for this study?
DermWorld: Your primary endpoint was reduction of itch. What did you find and was it what you expected to see?
Dr. Kwatra: There was a rapid and very significant reduction in itch in patients treated with nemolizumab. Improvements in itch were also accompanied by significant improvements in sleep and overall quality of life.
DermWorld: Was there a reason itch was chosen for the study rather than the skin lesions?
Dr. Kwatra: PN can be referred to as “the itch that rashes,” so it is important to study itch improvement as a primary endpoint. The improvement in skin lesions follows itch reduction and was also a co-primary endpoint and improved with therapy.
DermWorld: Did you encounter any unexpected side effects from the medication?
Dr. Kwatra: Nemolizumab is a q4 week injection that does not require routine laboratory monitoring and is generally well tolerated. Small subsets of patients experienced mostly mild-to-moderate eczematous dermatitis.
DermWorld: Dupilumab is FDA-approved for treatment of prurigo nodularis. How do these two drugs differ?
Dr. Kwatra: Dupilumab blocks IL-4 receptor alpha while nemolizumab blocks the IL-31 receptor. We are very lucky to have new therapeutics being developed for prurigo nodularis.
DermWorld: Can you predict how we will use nemolizumab in the future?
Dr. Kwatra: Nemolizumab has rapid effects on itch reduction so it will be a valuable addition to the therapeutic armamentarium for dermatologists.
Shawn G. Kwatra, MD, FAAD, is chair of the University of Maryland Department of Dermatology and serves as principal investigator of the Kwatra Lab. His paper appeared in The New England Journal of Medicine. Dr. Kwatra is a consultant and investigator for Galderma.
Disclaimer: The views and opinions expressed in this article do not necessarily reflect those of DermWorld.
Want to read more?
Check out the most popular Clinical Applications columns.
