Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Inflammopharmacology. 2024 Apr;32(2):991-1003. doi: 10.1007/s10787-024-01436-9. Epub 2024 Feb 8.
Prurigo nodularis (PN) is a neuroimmunological skin disease. Severe itching is the most challenging symptom which affects patients' quality of life. T helper 2-derived cytokines, such as interleukin-31 and oncostatin M (OSM), play a crucial role in PN pathogenesis. Nemolizumab and vixarelimab are two biologics acting as IL-31 inhibitors. Vixarelimab also suppresses the OSM activity. This systematic review evaluates the efficacy and safety of nemolizumab and vixarelimab in PN management.
A systematic search was conducted in PubMed/Medline, Ovid Embase, and Web of Science up to September 17th, 2023. Clinical trials and cohort studies published in English were included.
Among a total of 96 relevant records, five were included. The results of four studies with 452 patients using nemolizumab showed that a significantly higher percentage of patients treated with nemolizumab demonstrated a reduction in peak pruritus numerical rating scale (PP-NRS) and investigator's global assessment along with improved sleep disturbance (SD) and quality of life than the placebo group. Moreover, one study administered vixarelimab to 49 PN patients, and their finding illustrated a higher rate of subjects who received vixarelimab experienced ≥ 4-point diminution in worst itch NRS, visual analog scale, healing of representative lesions, and SD quality compared to the placebo group.
IL-31 inhibitors suggest distinct advantages in improving pruritus, sleep quality, and overall quality of life in subjects with moderate-to-severe PN. Further clinical studies are recommended to compare the effectiveness of these biologics to other therapeutic choices.
结节性痒疹（PN）是一种神经免疫性皮肤病。剧烈瘙痒是最具挑战性的症状，影响患者的生活质量。辅助性 T 细胞 2 衍生的细胞因子，如白细胞介素-31 和肿瘤坏死因子-α（OSM），在 PN 的发病机制中发挥着关键作用。Nemolizumab 和 vixarelimab 是两种作为 IL-31 抑制剂的生物制剂。Vixarelimab 还抑制 OSM 活性。本系统评价评估了 nemolizumab 和 vixarelimab 在 PN 管理中的疗效和安全性。
系统检索了 PubMed/Medline、Ovid Embase 和 Web of Science 数据库，检索时间截至 2023 年 9 月 17 日。纳入了发表在英文期刊上的临床试验和队列研究。
在总共 96 条相关记录中，有 5 条被纳入。四项研究共纳入 452 名使用 nemolizumab 的患者，结果表明，与安慰剂组相比，接受 nemolizumab 治疗的患者，其峰值瘙痒数字评分量表（PP-NRS）和研究者全球评估显著降低，睡眠障碍（SD）和生活质量得到改善。此外，一项研究对 49 名 PN 患者给予 vixarelimab，结果表明，与安慰剂组相比，接受 vixarelimab 治疗的患者，其最严重瘙痒 NRS、视觉模拟量表、代表性病变愈合和 SD 质量评分至少下降 4 分的比例更高。
IL-31 抑制剂在改善中重度结节性痒疹患者的瘙痒、睡眠质量和整体生活质量方面具有明显优势。建议开展进一步的临床研究，比较这些生物制剂与其他治疗选择的有效性。
