Clinical Trial Comparison of Dupilumab and Nemolizumab for Prurigo Nodularis FDA-Approved Biologic Therapy Selection in Prurigo Nodularis - PubMed
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- Prurigo nodularis (PN) is a chronic, itchy skin disorder with high morbidity and historically limited treatments.
- Dupilumab and nemolizumab are now FDA-approved biologic therapies for PN, changing the treatment landscape.
- This article reviews six randomized clinical trials (two for dupilumab, four for nemolizumab) from ClinicalTrials.gov through January 2025.
- Dupilumab showed sustained reductions in itch and lesions: 58-60% achieved ≥4-point improvement in WI-NRS, and 45-48% achieved IGA PN-S success by week 24.
- Nemolizumab had a faster onset: 41-56% achieved ≥4-point improvement in PP-NRS as early as week 4, with meaningful sleep improvements by week 16.
- Both therapies have manageable safety profiles, mainly mild to moderate adverse events, though nemolizumab had higher overall rates.
- Findings suggest dupilumab may offer greater lesion clearance later, while nemolizumab provides faster itch relief and less sleep disturbance.
- The study supports a phenotype-guided approach to biologic selection and calls for further comparative research.