ABSTRACT

Introduction

Prurigo nodularis (PN) or chronic prurigo of nodular type (CNPG) is a subtype of chronic prurigo with severe pruritus and neuroimmune underlying pathophysiology occurring in a plethora of dermatological, systemic, neurologic, and psychiatric conditions.

Areas covered

We review the increasing repertoire of biologics in the treatment of CNPG focusing on those targeting interleukins 4, 13, 31, oncostatin M and IgE. Presented information is based on a database research on current clinical trials (clinicaltrials.gov, European Clinical Trials Database (EudraCT), US clinical trial registry ICH-GCP) and a PubMed search for latest publications conducted with the combinations of the terms ‘chronic prurigo,’ ‘prurigo nodularis,’ ‘pathophysiology,’ ‘treatment,’ ‘therapy’, and ‘biologics.’

Expert opinion

CNPG gets more and more attention as new therapeutic targets have been revealed in recent years, thus allowing the use of targeted approaches. The off-label advent of dupilumab offered advanced insight into the pathogenesis of CNPG and showed an impressive relief of pruritus in the vast majority of patients. New therapies including biologics (e.g. nemolizumab, tralokinumab, lebrikizumab), small molecules (e.g. neurokinin-1 receptor antagonists, janus kinase inhibitors) as well as mu-opioid receptor antagonists and nalbuphine, a μ-antagonist/κ-agonist, are in the pipeline and offer new hope for an improved future patient care.

中文翻译：

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生物制剂在结节性痒疹中的治疗潜力

摘要

介绍

结节性痒疹 (PN) 或结节型慢性痒疹 (CNPG) 是慢性痒疹的一种亚型，伴有严重的瘙痒和神经免疫基础病理生理学，发生在过多的皮肤病、全身、神经和精神疾病中。

涵盖的领域

我们回顾了在 CNPG 治疗中越来越多的生物制剂，重点是针对白介素 4、13、31、制瘤素 M 和 IgE 的那些。提供的信息基于对当前临床试验的数据库研究（clinicaltrials.gov、欧洲临床试验数据库 (EudraCT)、美国临床试验注册机构 ICH-GCP）和 PubMed 搜索使用术语“慢性痒疹”组合进行的最新出版物、“结节性痒疹”、“病理生理学”、“治疗”、“疗法”和“生物制剂”。

专家意见

随着近年来新的治疗靶点的出现，CNPG 越来越受到关注，从而允许使用靶向方法。dupilumab 的标签外出现提供了对 CNPG 发病机制的深入了解，并在绝大多数患者中显示出令人印象深刻的瘙痒缓解。新疗法包括生物制剂（例如 nemolizumab、tralokinumab、lebrikizumab）、小分子（例如神经激肽-1 受体拮抗剂、janus 激酶抑制剂）以及 μ-阿片受体拮抗剂和 μ-拮抗剂/κ-激动剂纳布啡。管道，并为改善未来的患者护理提供新的希望。