Observations on the Efficacy andSafety 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.