A new review of treatments for prurigo nodularis has found the most promise in emerging therapies, including neurokinin-1 receptor antagonists, though the authors note that there is still a shortage of high-powered studies and randomized controlled trials for treatments for this condition.
“Currently, there is a lack of targeted pharmacologic therapy for prurigo nodularis and all current treatment approaches utilized show variable success,” said Dr. Adam Friedman, professor of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, D.C., in a press release on Dec. 13, 2018. “We wanted to provide a summary of evidence-based treatments to highlight promising directions and also underscore areas that require improvement.”
Dr. Friedman is the senior author of the review, which looked at clinical studies investigating prurigo nodularis treatment published between 1990 and the present that included five or more subjects.
A total of 35 studies were examined and given a score, ranked by the efficacy and consistency of the evaluated therapy against prurigo nodularis.
The team’s overall findings, published online ahead of print in Journal of the American Academy of Dermatology (Sept. 24, 2018), identified the most promise in several emerging treatments, including neurokinin-1 receptor antagonists—a class of medications often used to treat nausea and vomiting associated with chemotherapy. They note that the neurokinin-1 receptor is a target for the itch mediator known as substance P, which is a probable pathogenic agent of prurigo nodularis.
“By identifying which current and future therapies are effective for prurigo nodularis, we can gain a better understanding of the biological underpinnings of this disease, and patients will ultimately benefit from better treatment options,” Dr. Friedman said. “Our summary not only provides guidance for practitioners with regards to the broad array of off-label therapies in our armament, but also to researchers in identifying the gaps in treatment development.”
The team suggests that higher-powered studies and additional randomized controlled trials are needed to better evaluate treatment options for prurigo nodularis.