Kwatra Shawn G, Yang Min, Martins Bruno, Zion Abigail, Liu Jingyi, Zahn Joseph, Ozarslan Bengisu, Bahloul Donia, Payan Marine, Thomas Ryan B
Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA.
Analysis Group, Boston, MA, USA.
Adv Ther. 2025 Jul;42(7):3455-3471. doi: 10.1007/s12325-025-03217-4. Epub 2025 May 29.
This study assessed the comprehensive disease burden, the correlation among different patient-reported outcome measures (PROMs), and patient-reported treatment satisfaction with non-biologic agents in adult patients with prurigo nodularis (PN) in the United States.
A patient survey was conducted in the United States from June 30 to October 6, 2022, in patients with a self-reported diagnosis of PN. The survey included different PROMs assessing the symptoms and impacts of PN. The t test, chi-square test, Fisher's exact test, Spearman correlation, and Kendall correlation analysis were performed where applicable.
A total of 132 patients participated in the survey. Approximately 46%, 34%, and 20% of patients reported a worst itch-numeric rating scale (WI-NRS) score of ≥ 7, 3-6, and 0-2, respectively. Assessment of PROMs revealed that patients with a WI-NRS score of ≥ 7 (vs. 0-2) experienced more severe skin pain, neurological pain, greater negative impacts on quality of life (QoL), sleep disturbance, mental health, and work productivity and activity impairment (WPAI), as well as higher health care resource utilization (HCRU) (all p < 0.001). The proportion of patients satisfied with non-biologic treatment was significantly lower in patients with WI-NRS ≥ 7 (23.0% vs. 80.8% in WI-NRS 0-2). WI-NRS, Patient Global Impression of Severity (PGIS), average itch-NRS, and Dermatology Life Quality Index (DLQI) were strongly positively correlated (r ≥ 0.5) with each other and negatively correlated with Patient Global Assessment (PtGA) (r < - 0.5), while the number of nodules had weak correlations (absolute r < 0.3) with all PROMs except PGIS (r = 0.403) and PtGA (r = - 0.327).
In patients with PN, severe itching is associated with an increased symptom burden, greater disease impact, along with reduced satisfaction with non-biologic treatments. Additionally, the number of nodules alone may not adequately describe disease severity in patients with PN.
本研究评估了美国成年结节性痒疹（PN）患者的综合疾病负担、不同患者报告结局指标（PROMs）之间的相关性以及患者对非生物制剂治疗的满意度。
2022年6月30日至10月6日在美国对自我报告诊断为PN的患者进行了一项患者调查。该调查包括评估PN症状和影响的不同PROMs。在适用的情况下进行了t检验、卡方检验、Fisher精确检验、Spearman相关性分析和Kendall相关性分析。
共有132名患者参与了调查。分别约有46%、34%和20%的患者报告其最差瘙痒数字评定量表（WI-NRS）得分≥7、3-6和0-2。对PROMs的评估显示，WI-NRS得分≥7（与0-2相比）的患者经历了更严重的皮肤疼痛、神经疼痛，对生活质量（QoL）、睡眠障碍、心理健康以及工作效率和活动受损（WPAI）的负面影响更大，同时医疗保健资源利用（HCRU）更高（所有p<0.001）。WI-NRS≥7的患者对非生物治疗满意的比例显著低于WI-NRS为0-2的患者（23.0%对80.8%）。WI-NRS、患者总体严重程度印象（PGIS）、平均瘙痒数字评定量表和皮肤病生活质量指数（DLQI）彼此之间呈强正相关（r≥0.5），与患者总体评估（PtGA）呈负相关（r<-0.5），而结节数量与除PGIS（r=0.403）和PtGA（r=-0.327）之外的所有PROMs的相关性较弱（绝对r<0.3）。
在PN患者中，严重瘙痒与症状负担增加、疾病影响更大以及对非生物治疗的满意度降低相关。此外，仅结节数量可能无法充分描述PN患者的疾病严重程度。
