Dupilumab-Treated Patients With Prurigo Nodularis Report Disease Control and Treatment Satisfaction: 6-Month Results From the RELIEVE-PN Study

Abstract

Introduction Dupilumab, a fully human VelocImmune®-derived monoclonal antibody, is the first approved treatment in the US for adult patients with prurigo nodularis (PN). This real-world analysis evaluated improvements in disease control, concomitant medication use, and treatment satisfaction among the dupilumab-treated adult patients with PN in the US.

Methods RELIEVE-PN is an ongoing longitudinal prospective patient survey study assessing the real-world effectiveness of dupilumab in the treatment of adults with PN. Adult patients with PN were recruited through the US dupilumab patient support program; they were surveyed before (baseline) and 1, 2, 3, and 6 months after dupilumab initiation. Disease control over the past 2 weeks was assessed using the Prurigo Control Tool (PCT; range: 0–20; scores ≥10 indicate controlled chronic prurigo). Concomitant medication use over the past 4 weeks was patient-reported and included topical treatments, oral corticosteroids, oral pain medications, oral antidepressants, and oral anxiolytics. Patient-reported satisfaction with the current treatment(s) was evaluated using a 7-point Likert scale, which ranged from “extremely satisfied” to “extremely dissatisfied.” A subgroup analysis was conducted for patients who continued 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 treatment, 156, 130, and 85 patients completed the survey at months 1, 3, and 6, respectively; their characteristics were similar to baseline patient characteristics. At baseline, 12.7% patients had well-controlled chronic prurigo, and 22.1% were satisfied with non-dupilumab treatments; patients were treated with topical treatments (89.5%), oral corticosteroids (12.7%), oral pain medications (71.8%), oral antidepressants (43.1%), and oral anxiolytics (45.3%) in the past month. At Months 1, 3, and 6, 51.9%, 66.9%, and 63.5% patients, respectively, had well-controlled prurigo, and 69.9%, 86.2%, and 70.6% patients, respectively, were satisfied with their PN treatments (p<0.001 vs baseline values for all). Among the 67 patients who continued dupilumab treatment at month 6, 71.6% had well-controlled prurigo and 85.1% were satisfied with the treatment. The proportion of patients on concomitant treatments in the past month decreased over time. At Month 6, patients were on topical treatments (68.2%), oral corticosteroids (5.9%), oral pain medications (30.6%), oral antidepressants (29.4%), and oral anxiolytics (30.6%) in the past 4 weeks. Among the patients who continued dupilumab treatment at month 6, 68.7%, 3.0%, 29.9%, 28.4%, and 29.9% were treated with topical treatments, oral corticosteroids, oral pain medications, oral antidepressants, and oral anxiolytics, respectively, in the past 4 weeks.

Conclusion The results from this real-world RELIEVE-PN study demonstrate improvements in patient-reported disease control, reduction in concomitant medication use, and treatment satisfaction in dupilumab-treated patients with PN as early as 1 month and further maintained till 6 months post treatment.