Dupixent has long been known as a therapy which reduces itch, slows disease progression, and reduces exacerbations in a number of allergic conditions such as asthma, eczema, and nasal polyps. This treatment is also used for eosinophilic esophagitis (EoE) and prurigo nodularis. Incyte, a global biopharmaceutical company, is working on a therapy that could transform the treatment landscape for people with prurigo nodularis – and may show similar efficacy to Dupixent.
As Nick Paul Taylor reports in Fierce Biotech, Incyte’s results from a Phase 2 clinical study suggest that povorcitinib, an oral small-molecule JAK1 inhibitor, performed well in relieving prurigo nodularis severity. 146 adults enrolled in the study. These participants had not responded well to prior treatments. During the study, participants received either a placebo or one of three povorcitinib doses. The research team found that:
- Following a 16-week treatment period, between 36.1-54.1% of participants receiving povorcitinib experienced less itchiness and lowered itch severity. This is compared to just 8.1% of people receiving the placebo. Comparing this to Dupixent in a Phase 3 study, 57.7-60% of participants receiving Dupixent saw the same itch reduction, with 18.4-19.5% of those on the placebo seeing itch improvements.
- 75mg povorcitinib seemed to be the most effective dose. People receiving the higher dose experienced improvement more quickly than those taking the lower dose.
Moving forward, Incyte aims to develop a Phase 3 clinical study to further evaluate povorcitinib for prurigo nodularis.
About Prurigo Nodularis
Prurigo nodularis is a chronic inflammatory skin disorder characterized by the formation of intensely itchy nodules. The National Organization for Rare Disorders (NORD) explains that:
PN can appear on its own or be associated with other skin diseases or underlying medical conditions that affect multiple body systems, such as cancer, diabetes, chronic kidney disease or AIDS. The exact cause of PN is unknown but altered function of the immune system and nerves in the skin is believed to be associated with heightened sensations of itchiness (pruritus) that leads to frequent scratching and picking [that] is also thought to contribute to further lesion thickening and formation.
While prurigo nodularis can affect people of all ages, it is most common in older individuals. When prurigo nodularis occurs in younger individuals, it is more likely to be linked to inflammatory skin diseases like eczema.
People with prurigo nodularis develop an itchy, symmetrically distributed rash. It can occur on areas of the arms, legs, upper back, scalp, and abdomen. Yale Medicine says that:
Difficult to reach places like the upper portion of the middle back are usually spared, and nodules generally do not form on the palms or soles of the feet, or face.
The rash begins with intense skin itching, burning, and stringing. This itch is often severe, episodic, long-lasting (6+ weeks), and made worse by stress, sweat, heat, or clothing rubbing against it. When it comes to the actual appearance of prurigo nodularis, the rash can differ from patient to patient. Some individuals have just a few firm, dome-shaped papules, nodules, or plaques, while others can have hundreds. These nodules may range in size from 0.5cm to 2cm wide and may also differ in color. As people scratch at the skin, the skin becomes thickened, scarred, and discolored.
In most cases, prurigo nodularis will not heal on its own. While there are no FDA-approved treatments specifically designed for prurigo nodularis, there are ways to manage this condition. Doctors may treat this condition with lifestyle modifications, corticosteroids, antihistamines, phototherapy, immunomodulatory drugs, and over-the-counter ointments or lotions. If you have prurigo nodularis, please speak with your doctor about which option is best for you.
