Dupilumab treatment for prurigo nodularis: a retrospective study of 76 patients

Introduction:
Prurigo nodularis (PN) is a chronic pruritic and inflammatory skin disorder and dupilumab is currently the only biologic agent approved in China for the treatment.

Aim:
To evaluate the efficacy and safety of dupilumab in managing moderate to severe PN through a retrospective study of 76 patients.

Material and methods:
A retrospective analysis was conducted of clinical and laboratory data from PN patients who received regular dupilumab treatment for 52 weeks at the Dermatology Department of the Second Affiliated Hospital of Soochow University between March 2021 and June 2023. Assessments were made at baseline (week 0), and at weeks 4, 8, 16, 26, and 52 using prurigo nodule counts, Investigator’s Global Assessment (IGA) scores, Pruritus Numeric Rating Scale (NRS) scores, and Dermatology Life Quality Index (DLQI) scores to evaluate clinical symptoms and pruritus. Adverse events occurring post-treatment were also recorded to assess the drug’s safety and efficacy.

Results:
A total of 76 patients with moderate to severe PN were included in this study. By week 52, there were significant reductions in prurigo nodule counts, IGA scores, NRS scores, and DLQI scores. Prurigo nodule counts decreased from a baseline of 74.64 ±33.45 to 2.3 ±0.9, IGA scores from 3.53 ±0.54 to 0.54 ±0.33, NRS scores from 7.65 ±2.27 to 1.01 ±0.65, and DLQI scores from 18.46 ±4.53 to 1.55 ±0.68, with all differences being statistically significant (p < 0.05). Seven patients experienced injection site reactions, and 2 patients developed facial erythema, which resolved either spontaneously or with symptomatic treatment. No other adverse events were reported.

Conclusions:
Dupilumab effectively reduces the number of PN, improves IGA scores, alleviates pruritus, and enhances quality of life in patients with moderate to severe PN, with a high safety profile.