成功使用度普利尤单抗治疗结节性痒疹：24 例患者报告。

Successful Treatment of Prurigo Nodularis by Dupilumab: Report of 24 Patients.

机构信息

Dermatology and Venereology, Peking University People's Hospital, Beijing, China,

Dermatology and Venereology, Peking University People's Hospital, Beijing, China.

出版信息

Dermatology. 2023;239(4):658-663. doi: 10.1159/000529965. Epub 2023 Apr 3.

DOI:10.1159/000529965

PMID:37011607

Abstract

BACKGROUND

Prurigo nodularis (PN) is a chronic pruritic skin disease which is difficult to treat. Current treatment options often lead to limited clinical benefit or severe side effects.

OBJECTIVE

The objective of this study was to evaluate the efficacy and safety of dupilumab in the treatment of PN in adults.

METHOD

This study is a retrospective cohort study. Twenty-four adult patients with PN were included and treated with dupilumab. The primary outcomes were the mean reduction in the Investigator's Global Assessment (IGA) score and pruritus numeric rating scale (p-NRS) score. Outcomes were assessed at baseline, week 4, week 16, and week 36.

RESULTS

The study included 24 patients, of whom 9 (37.5%) were male, and the mean (SD) age of the enrolled patients was 49.88 ± 16.71 years. At the end of the 16-week treatment, the mean p-NRS score decreased from 7.50 ± 2.21 to 1.41 ± 0.91 (p < 0.001), sleeplessness numeric rating scale (s-NRS) score declined from 5.33 ± 3.29 to 0.18 ± 0.59 (p < 0.001), and Dermatology Life Quality Index (DLQI) score decreased from 13.32 ± 4.88 to 0.91 ± 0.81 (p < 0.001). Fourteen (63.6%) of 22 patients achieved IGA 0/1 and 21 (95.5%) patients achieved IGA activity 0/1. Among 14 patients who achieved IGA 0/1, 10 had an elevated serum IgE level, and patients with a high serum IgE level showed a more remarkable reduction in IGA (r = 0.52, p = 0.03). Patients with AD responded faster than those without AD (3.76 ± 1.71 weeks vs. 6.40 ± 1.67 weeks, p = 0.01). Adverse events were recorded in 4/24 (16.6%) patients, with conjunctivitis being the most frequent.

CONCLUSION

This study demonstrated that dupilumab is effective and safe for PN and could be a potential therapeutic option.

摘要

背景

结节性痒疹（PN）是一种慢性瘙痒性皮肤病，难以治疗。目前的治疗选择往往导致有限的临床获益或严重的副作用。

目的

本研究旨在评估度普利尤单抗治疗成人 PN 的疗效和安全性。

方法

这是一项回顾性队列研究。共纳入 24 例 PN 成年患者，接受度普利尤单抗治疗。主要结局为研究者全球评估（IGA）评分和瘙痒数字评分量表（p-NRS）评分的平均降低。在基线、第 4 周、第 16 周和第 36 周进行评估。

结果

该研究共纳入 24 例患者，其中 9 例（37.5%）为男性，纳入患者的平均（SD）年龄为 49.88 ± 16.71 岁。在 16 周治疗结束时，p-NRS 评分从 7.50 ± 2.21 降至 1.41 ± 0.91（p < 0.001），失眠数字评分量表（s-NRS）评分从 5.33 ± 3.29 降至 0.18 ± 0.59（p < 0.001），皮肤病生活质量指数（DLQI）评分从 13.32 ± 4.88 降至 0.91 ± 0.81（p < 0.001）。22 例患者中有 14 例（63.6%）达到 IGA 0/1，21 例（95.5%）达到 IGA 活动 0/1。在 14 例达到 IGA 0/1 的患者中，10 例血清 IgE 水平升高，高血清 IgE 水平的患者 IGA 降低更明显（r = 0.52，p = 0.03）。AD 患者比非 AD 患者起效更快（3.76 ± 1.71 周比 6.40 ± 1.67 周，p = 0.01）。4/24（16.6%）例患者出现不良事件，以结膜炎最常见。