New Data Characterizes Burden of Pruritus in Patients with Chronic Dermatoses

Tomasz Hawro, MD

Effective clinical treatment strategies are currently needed to treat pruritus and the underlying skin disease. However, for that to happen, more research is needed on the condition.

A team, led by Tomasz Hawro, MD, Department of Dermatology and Allergy, Berlin University of Medicine, investigated the characteristics, including localization patterns, and burden of pruritus in patients with chronic dermatoses.

Pruritus often comes with chronic skin disease, exerting considerable burden on several different areas of patient functioning. However, this burden and the features of pruritus are not sufficiently characterized.

The investigators recruited approximately 800 patients with active chronic skin diseases for the study. The research team assessed pruritus intensity, localization, and further characteristics. The researchers also validated questionnaires to assess the quality of life, work productivity and activity impairment, anxiety, depression, and sleep quality.

Overall, 9 out of every 10 participant had experienced pruritus throughout their disease, including 73% in the previous 7 days.

The team also found that pruritus often impacted the entire body and was not restricted only to skin lesions. Patients with moderate to severe pruritus reported significantly more impairment to their sleep quality and work productivity.

These patients were also more depressed and anxious than the control group, as well as patients with mild or no pruritus.

Suicidal ideations were also highly prevalent in patients with chronic pruritus (18.5%) and atopic dermatitis (11.8%).

Last year, investigators found higher-dose ligelizumab was linked to a greater rate of complete symptom control among patients with chronic spontaneous urticaria.

The investigative IGHE-binding immunomodulator developed by Novartis was shown to benefit patient control of hives when compared to treatment with omalizumab or placebo.

Though chronic spontaneous urticaria is known to involve autoimmune mechanisms via IgG autoantibodies against the high-affinity receptor for the Fc region of IgE in a majority of its patients, current treatment is not a treat-all standard.

Ligelizumab was shown in previous trials to suppress IgE in dose- and time-dependent instances, and to provide a superior response to allergen in skin-prick tests compared to omalizumab.

At week 12, a total of 30%, 51%, 42% of patients treated with 24 mg, 72 mg, 240 mg of ligelizumab, respectively, reported complete hives control. Just 26% of patients on omalizumab achieved this mark, and none on placebo. Investigators establish a dose-response relationship.

Another 30%, 44%, and 40% of the ligelizumab-treated patients in their respective dosing groups reported complete symptom control at week 12—again improving on the 26% of patients in the omalizumab arm, and none in the placebo arm.

No safety concerns in ligelizumab- nor omalizumab-treated patients were observed, though investigators noted the trial was small in scale and short in duration. The team concluded rates of complete symptom control in patients treated with 72-mg and 240-mg ligelizumab was statistically significant than the rates of patients on omalizumab or placebo.

While new treatments can be tested and proven effective, the research process could be event more successful if researchers learn more about the underlying characteristics of the disease.

“Pruritus prevalence and intensity are very high across all dermatoses studied; intensity is linked to impairment in many areas of daily functioning,” the authors wrote.

The study, “The characteristics and impact of pruritus in adult dermatologic patients: A prospective, cross-sectional study,” was published online in the Journal of the American Academy of Dermatology.