A pathology still difficult to recognize exactly and to treat, but new treatments are on the way that can improve the lives of patients
And incessant itchingfirst localized and with the passing of time more and more disseminated, to which is added the formation of thick skin lesions, similar to nodules, which can affect a large part of the body. This is how the “prurigo nodularis», A rare disease, but with a very serious impact for the patients who are afflicted by it. The injuries are often painfulbecause they cause acute burning and tingling of the skin, and together with intense and persistent itching, they worsen the quality of life of patients to such an extent that it is impossible for many to lead a normal existence. The available therapies, in fact, are able to offer only a partial and temporary benefit. But something is finally about to change, as indicated by the results of some studies presented in recent days in Milan, during the congress of the European Academy of Dermatology and Venereology (Eadv).
“There are currently no approved drugs that are specifically indicated for the treatment of prurigo nodularis, that is a chronic debilitating diseasewith very serious consequences for those affected – he explains Antonio Costanzo, director of the Dermatology department at the Humanitas Clinical Institute in Milan -. The incessant itching (even at night, causing insomnia) and the pain in many cases end up negatively affecting mental health, on the activities of daily life, at work and on social interactions. At the moment the treatments foresee topical therapies (drugs in cream or gel to be applied to the skin) e antihistamines which have a limited effect and which cannot be taken for years without “paying a price” in side effects ». They are studied however new drugs and one option for patients is to receive them by joining experimental protocolswhich are in progress at an international level and are also available in some specialized centers in Italy.
The results of the PRIME (phase 3) study, presented at the EADV conference, indicate that treatment with the drug dupilumab he’s able to significantly reduce itching and skin lesions at 24 weeks. The trial recruited 151 adults with uncontrolled prurigo nodularis through treatments already prescribed and treated with the new drug or with a placebo: “Relieving itching and restoring skin integrity are the priorities for patients – continues Costanzo – and the outcomes of the trial show that dupilumab has the potential to address and enable management of these debilitating symptoms, even reaching skin without or almost lesions. With minimal toxicityas already demonstrated by this monoclonal antibody which is currently used (and also approved in Italy) for other pathologies, such as atpoic dermatitis, asthma and chronic rhinosinusitis with nasal polyposis. Thanks to the progress of research, other drugs are being tested for this pathology, such as a monoclonal antibody called nemolizumabaimed at interrupting the vicious circle itching-scratching-lesion that characterizes the disease ».
A more feminine disease
It is a long-lasting disease, more frequent and severe in women, which often occurs in middle-aged people. It is difficult to say exactly how many people suffer from prurigo nodularis: unfortunately there is a lack of accurate epidemiological studies, also due to difficulties in cataloging it exactly. «Very often, in fact, it is associated with other diseases such as atopic dermatitis of which it can be a clinical variant, renal insufficiency, depression, dyslipidemias that can mask the correct classification of prurigo – concludes the expert -. It is essential that patients are followed up in Specialized centers where, in addition to therapy, they can be advised on lifestyle and nutrition more correct to follow in order not to aggravate the pathology “.
September 27, 2022 (change September 27, 2022 | 18:28)