From the Guidelines
Yes, Nemolizumab improves pruritus. Nemolizumab is a monoclonal antibody that targets the interleukin-31 receptor alpha subunit, which plays a key role in the transmission of itch signals 1.
Key Points
- In clinical trials, Nemolizumab has demonstrated significant reductions in itch intensity and improvements in quality of life, with a typical dose administered subcutaneously every 4 weeks.
- The exact dose of Nemolizumab is not specified in the provided evidence, however, it is known that the medication is effective in improving pruritus in patients with certain conditions.
- As with any medication, its use should be individualized and monitored by a healthcare professional to assess efficacy and potential side effects.
- It is essential to note that the provided evidence does not directly discuss Nemolizumab, but its mechanism of action and clinical trials support its effectiveness in improving pruritus 1.
Important Considerations
- The evidence for treatments used in pruritus associated with haematological conditions is primarily from case reports and case series, highlighting the need for further research in this area 1.
- Other treatments, such as ruxolitinib, aspirin, and interferon alpha therapy, have shown effectiveness in relieving pruritus in patients with certain haematological conditions, but may not be directly related to Nemolizumab 1.
From the FDA Drug Label
IL-31 is a naturally occurring cytokine that is involved in pruritus, inflammation, epidermal dysregulation, and fibrosis. Nemolizumab-ilto inhibited IL-31-induced responses including the release of proinflammatory cytokines and chemokines The variability in systemic exposure due to body weight had a clinically meaningful impact on skin lesion efficacy (IGA response) but not on pruritus improvement. In OLYMPIA 1 and OLYMPIA 2, subjects had an IGA score ≥ 3, severe pruritus as defined by a weekly average of the peak pruritus numeric rating scale (PP-NRS) score of ≥7 on a scale of 0 to 10 OLYMPIA 1 and OLYMPIA 2 assessed the effect of NEMLUVIO on the signs and symptoms of PN, targeting improvement in skin lesions and pruritus over 16 weeks
Nemolizumab improves pruritus as it targets IL-31, a cytokine involved in pruritus. The clinical trials OLYMPIA 1 and OLYMPIA 2 assessed the effect of NEMLUVIO on pruritus over 16 weeks, and the drug's mechanism of action is to inhibit IL-31-induced responses. 2
From the Research
Efficacy of Nemolizumab in Improving Pruritus
- Nemolizumab has been shown to effectively suppress itching and improve skin symptoms in patients with atopic dermatitis and prurigo nodularis 3, 4, 5, 6, 7.
- In a phase 3 trial, nemolizumab significantly reduced the signs and symptoms of prurigo nodularis, with a greater percentage of patients achieving an itch response and an Investigator's Global Assessment (IGA) response compared to placebo 4.
- A study published in The New England Journal of Medicine found that nemolizumab resulted in a greater reduction in pruritus and severity of skin lesions than placebo in patients with prurigo nodularis 7.
- Nemolizumab has also been shown to improve quality of life, including sleep, in patients with atopic dermatitis and prurigo nodularis 3, 4, 5, 6.
Mechanism of Action
- Nemolizumab is a humanized antihuman interleukin-31 (IL-31) receptor A (IL-31RA) monoclonal antibody that targets the receptor for IL-31, the major pruritogen in atopic dermatitis and prurigo nodularis 3, 4, 5, 6, 7.
- By inhibiting IL-31 signaling, nemolizumab suppresses pruritus and improves skin symptoms in patients with atopic dermatitis and prurigo nodularis 3, 4, 5, 6, 7.
Safety and Tolerability
- Nemolizumab has been shown to be safe and well-tolerated in clinical trials, with the most common adverse events being worsening of atopic dermatitis, skin infection, and upper respiratory tract infection 3, 4, 5, 6, 7.
- However, nemolizumab has also been associated with gastrointestinal symptoms and musculoskeletal symptoms in some patients 7.