Observations on the Efficacy and Safety of Dupilumab as an Anti-Itch Agent in Special Populations

Background Dupilumab relieves inflammatory response and alleviates skin itch  by  blocking  interleukin-4  (IL-4),  interleukin-13  (IL- 13)  in  relevant signalling pathways. It also needs further research into efficacy and safety of dupilumab as a pruritus relieving agent in specific populations. Objective This  study  aimed  to  observe  the  efficacy  and  safety  of dupilumab  as  a pruritus relief agent  in  specific populations.  Methods  Thirty-one patients with pruritus (28 systemic and 3 idiopathic) were treated with subcutaneous injections of dupilumab. Efficacy was assessed before treatment, at 4 weeks post-treatment, and at 8 weeks post-treatment. Results After 4 weeks of treatment, the effectiveness rate was 70.4%, and after 8 weeks of treatment, the effectiveness rate was 96.3%; compared with before treatment, the NRS scores of pruritus decreased after 4 weeks of treatment and 8 weeks  of treatment  significantly. The difference of NRS scores was statistically significant (F= 103.679, P<0.001). The adverse reactions were few and mild. Conclusions  For  pruritus,  especially  for  extreme  itch  caused  by  tumors, severe renal dysfunction, diabetes, and other diseases in special patients, the short-term results show that dupilumab had a good efficacy and acceptable safety in this small case sequence study. However, because of the absence of a control group and the open label feature, the present results are preliminary. Randomized controlled trials are needed to confirm its role.