Dupilumab-Treated Patients With Prurigo Nodularis Experience Improvements in Itch and Skin Pain: 6-Month Results From the RELIEVE-PN Study

Abstract

Introduction Patients with prurigo nodularis (PN) experience significant itch, skin pain, and skin burning/stinging. Dupilumab, a fully human VelocImmune®-derived monoclonal antibody, was the first approved treatment for patients aged ≥18 years with PN in the United States (US). This analysis evaluated improvements in itch, skin pain, and skin burning or stinging/tingling in US adults with PN treated with dupilumab in the real-world setting.

Methods RELIEVE-PN is an ongoing longitudinal prospective patient survey study assessing the real-world effectiveness of dupilumab in the treatment of adult patients with PN. Adults with PN were recruited through the US dupilumab patient support program and surveyed before (baseline) and 1, 2, 3, and 6 months after dupilumab initiation. Patients reported PN symptoms over the last 7 days using the worst itch-numeric rating scale (WI-NRS), average itch-NRS, skin pain NRS, and skin burning or stinging/tingling NRS (range 0 [no symptoms] to 10 [most severe symptoms] for all). The mean scores based on outcomes were compared to baseline values using t-tests. A subgroup analysis was conducted on patients who remained under treatment at the time of the surveys.

Results Of the 181 patients (mean age, 57.9 years; 78.5% female; 85.6% White) who completed the baseline survey and initiated dupilumab, 156, 130, and 85 patients completed the Month 1, 3, and 6 surveys, respectively. Characteristics of patients who completed Month 1, 3, and 6 surveys were similar to baseline patient characteristics. At baseline, the mean (standard deviation) WI-NRS, average itch-NRS, skin pain NRS, and skin burning/tingling NRS scores were 7.6 (2.3), 6.3 (2.3), 4.9 (2.9), and 5.3 (3.0), respectively. The mean (SD) WI-NRS and average itch-NRS scores at months 1, 3, and 6 were 6.0 (2.9), 5.1 (2.8), and 4.7 (2.9), and 4.5 (2.4), 3.9 (2.5), and 3.5 (2.3), respectively (p<0.001 compared to baseline values for all). The mean (SD) Skin pain NRS and skin burning or stinging/tingling NRS scores were 3.6 (2.5), 3.2 (2.6), and 2.7 (2.3) and 3.9 (2.7), 3.3 (2.6), and 3.0 (2.7) at months 1, 3, and 6, respectively (p<0.001 compared to baseline values for all). Among the 67 patients continuing to take dupilumab at 6 months, the WI-NRS, average itch NRS, skin pain NRS, and skin burning/tingling NRS scores were 4.4 (2.8), 3.3 (2.3), 2.4 (2.2), and 2.6 (2.6), respectively.

Conclusion Results from the real-world RELIEVE-PN study demonstrate improvement in patient-reported itch, skin pain, and skin burning or stinging/tingling in patients with PN treated with dupilumab as early as 1 month and continued over the 6 months post treatment.