Trial of Nemolizumab in Moderate-to-Severe Prurigo Nodularis

RCT (n=70) found this monoclonal antibody targeting IL-31 receptor, resulted in greater reduction in pruritus (p<0.001) and severity of skin lesions vs.placebo in patients with this chronic pruritic skin disease with multiple nodular skin lesions, but was linked to adverse events

SPS commentary:

According to an editorial, the apparent long duration of itch relief with nemolizumab is noteworthy, as patients received their last dose at week 8, and 2 months later, while off therapy, they still had a 60% reduction in peak pruritus, as compared with 28% for placebo. It notes that a limitation of the present trial is a lack of racial diversity; the majority of patients were white, and all the patients were enrolled at European centre; in US, prurigo nodularis disproportionately affects black patient and tends to manifest with more deep-seated nodules than in white patients, which suggests possible molecular heterogeneity and potential differential responses to treatment. It concludes that with “this potential new era in prurigo nodularis, efforts are needed to increase disease awareness as new therapeutic agents become available. The results of this trial provide hope for this population of patients with intractable itch.”


New England Journal of Medicine