New study investigates treatments for prurigo nodularis

December 13, 2018

WASHINGTON (Dec. 13, 2018) -- Prurigo nodularis is a disabling chronic skin condition characterized by severely itchy, crusty, firm papules and nodules that often occur on the arms and legs, but can appear diffusely on the body. The pathogenesis of prurigo nodularis is poorly understood, as this condition has been associated with a broad array of primary skin and underlying medical diseases affecting the liver, kidneys, and blood.

Regardless of the cause of these lesions, impact on quality of life for these patients can be tremendous, as the itch associated with the lesions can both aggravate and initiate stress, further perpetuating the itch-scratch cycle and induce further lesion formation. Many of the treatment options, including topical agents, phototherapy, and systemic immunomodulatory drugs, show limited promise due to side effects and low efficacy.

A team at the George Washington University (GW) has conducted a systematic review of clinical studies investigating prurigo nodularis treatment published between 1990 and the present that include at least five subjects.

"Currently, there is a lack of targeted pharmacologic therapy for prurigo nodularis and all current treatment approaches utilized show variable success," said Adam Friedman, MD, professor of dermatology at the GW School of Medicine and Health Sciences and senior author on the study. "We wanted to provide a summary of evidence-based treatments to highlights promising directions and also underscore areas that require improvement."

Friedman and his team looked at 35 studies with differences in factors such as the number of subjects and the delivery of the treatment. They gave a score to each study, ranking its efficacy and consistency against prurigo nodularis.

In the review, the team found the most promise in emerging treatments, such as neurokinin-1 receptor antagonists, part of a drug class used to treat nausea and vomiting associated with chemotherapy. The receptor is a target of substance P, a mediator of itch and 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," 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.
-end-
The review, titled "A Systematic Review of Evidence-Based Treatments for Prurigo Nodularis," can be found in the Journal of the American Academy of Dermatology at http://www.jaad.org/article/S0190-9622(18)32628-8/fulltext.

Media: To interview Dr. Friedman, please contact Ashley Rizzardo at amrizz713@gwu.edu or 202-994-8679.

About the GW School of Medicine and Health Sciences

Founded in 1824, the GW School of Medicine and Health Sciences (SMHS) was the first medical school in the nation's capital and is the 11th oldest in the country. Working together in our nation's capital, with integrity and resolve, the GW SMHS is committed to improving the health and well-being of our local, national and global communities. smhs.gwu.edu

George Washington University

Related Treatment Articles from Brightsurf:

Treatment for teen anxiety
In a new National Institute of Mental Health-funded study, led by Jeffrey Strawn and published in the Journal of Clinical Psychiatry, UC researchers took a first look at one particular medication for treatment of anxiety disorders in pediatric patients to see if it was beneficial.

A sound treatment
University of Utah biomedical engineering assistant professor Jan Kubanek has discovered that sound waves of high frequency (ultrasound) can be emitted into a patient's brain to alter his or her state.

A new treatment for liver cancer
In the latest issue of Molecular Therapy, Skoltech and MIT researchers have published a new combinatorial therapy for the treatment of liver cancer.

Improving the treatment of periodontitis
For the first time, researchers from Charité -- Universitätsmedizin Berlin have shown that a unicellular parasite commonly found in the mouth plays a role in both severe tissue inflammation and tissue destruction.

Excellent long-term stability of treatment gains of stepwise treatment for pediatric OCD
A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that the long-term stability of treatment gains for children and adolescents diagnosed with obsessive-compulsive disorder (OCD), participating in a stepwise manualized treatment, is excellent.

When the best treatment for hypertension is to wait
A new study concluded that a physician's decision not to intensify hypertension treatment is often a contextually appropriate choice.

Is opioid treatment available to those who need it most?
The US opioid epidemic is still raging -- it's particularly pronounced in low-income areas and in those where people lack access to health care services, which includes cities in Michigan and across the Rust Belt.

Virus characteristics predict HIV treatment efficacy with antibody treatment
Current HIV-1 therapies have been proven to be highly effective in slowing the progression of the virus in the body with only minimal side effects.

Light therapy could replace opioids as main treatment for cancer treatment side effect
A worldwide coalition of researchers and clinicians has agreed that light therapy is among the most effective interventions for the prevention of oral mucositis, painful ulcers in the mouth resulting from cancer therapy.

Minimally invasive uterine fibroid treatment safer and as effective as surgical treatment
Uterine fibroid embolization (UFE) effectively treats uterine fibroids with fewer post-procedure complications compared to myomectomy, according to new research presented today at the Society of Interventional Radiology's 2019 Annual Scientific Meeting.

Read More: Treatment News and Treatment Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.