Objective:

To evaluate the efficacy of nemolizumab in reducing itch and sleep disturbance in patients with moderate-to-severe atopic dermatitis and prurigo nodularis.

Key Findings:

• 10.7% of nemolizumab-treated patients achieved an itch response by day 2 compared to 2.9% in placebo for atopic dermatitis.
• By day 14, response rates increased to 25.5% in the nemolizumab group versus 8.9% in placebo for atopic dermatitis.
• In prurigo nodularis, 17.2% of nemolizumab-treated patients achieved an itch response by day 2 compared to 3.7% in placebo, increasing to 37.0% versus 10.2% by day 14.
• Early itch response was associated with sustained benefit at week 16.

Interpretation:

Targeting the IL-31 pathway with nemolizumab provides rapid and significant itch relief, which may improve quality of life for patients.

Limitations:

• Post hoc analysis; early itch response was not a prespecified endpoint.
• Nominal P values reported without adjustment for multiple comparisons.
• Background topical therapy was allowed in atopic dermatitis trials but not in prurigo nodularis trials.

Conclusion:

Nemolizumab demonstrates rapid itch relief and improvement in sleep disturbance, suggesting a beneficial impact on quality of life for patients with atopic dermatitis and prurigo nodularis.