Investigation of the effect of nemolizumab on pruritus in patients with atopic dermatitis

This retrospective observational study assessed the effectiveness of nemolizumab in treating atopic dermatitis (AD)-associated pruritus. The data of 17 patients who received nemolizumab for AD associated pruritus from August 2022 to March 2023 and did not respond satisfactorily to existing treatments were analyzed. The findings revealed that 17 patients achieved 1/2 numerical rating scale (NRS) (reduced to 1/2 compared with the pretreatment NRS) within 3 days after nemolizumab administration. Additionally, 13 patients achieved NRS0/1 within 7 days of treatment. Within 28 days，10, 6, and 5 patients achieved. Eczema Area and Severity Index (EASI) 50, 75, and 90 percent improvement responses, respectively. Blood test results indicated that immunoglobulin E (IgE) levels were elevated in 7/12 patients, thymus and activation-regulated chemokine (TARC) levels were elevated in 9/11 patients, and eosinophil count was elevated in 8/12 patients after nemolizumab treatment. These markers were deemed unsuitable for determining treatment effectiveness. Adverse reactions included edematous erythema in 7 patients，relatively fine papules, erythema and vesicles reminiscent of autosensitization dermatitis in 6 patients, and dryness and tightness of the skin in 2 patients. In the analysis of 24 patients with severe AD treated with dupilumab, for comparative purposes to examine the appropriate clinical features, it took ≥14 days to achieve 1/2NRS in 12 patients, and 8 patients failed to achieve NRS0/1. For those with rash, EASI 50, 75, and 90 responses were achieved within 28 days by 21, 8, and 2 patients, respectively. Pretreatment and post-treatment blood test results revealed that IgE levels decreased in 9/10 patients, TARC decreased in 10/10 patients, and eosinophil count remained unchanged in 9/10 patients. These findings suggest that nemolizumab administration can rapidly improve pruritus.