Baricitinib for the Treatment of Chronic Pruritus of Unknown Origin

IF 3.7 4区 医学 Q1 DERMATOLOGY Dermatologic Therapy Pub Date : 2024-11-01 DOI:10.1155/2024/5531111
Wei Hua, Yingrou Tan, Hong Liang Tey
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Abstract

Background: Chronic pruritus of unknown origin (CPUO) is a highly debilitating disease that lacks effective treatment. There have been case reports of effective use of Janus Kinase (JAK) inhibitors in CPUO, including a case treated with baricitinib, a selective JAK 1/2 inhibitor.

Objectives: To evaluate if itch in a cohort of CPUO patients was effectively reduced after treatment with baricitinib.

Patients and Methods: This is a retrospective case series examining all patients with CPUO who were treated with baricitinib from February 2022 to August 2023 at the National Skin Center, Singapore. Itch scores on a 0–10 numerical rating scale (NRS) at 0.5-point intervals were recorded and analyzed over time.

Results: Sixteen patients (56% women, mean age of 62.2 ± 19.7 years old) with CPUO were included in the analysis. Their mean [range] duration of chronic itch was 15.4 [1–50] years, and the mean follow-up period of baricitinib treatment was 10.2 ± 6.7 months. The median [IQR] NRS itch score before and after baricitinib treatment were 8.5 [6.5–10.0] and 3.5 [1.25–5.0], respectively, with a mean reduction in the itch score of 4.9 ± 2.7 (p < 0.0001). All except one patient reported significant improvement in itch severity. There were no reports of symptomatic side effects, except for a drop in hemoglobin in a patient with thalassemia and a dry throat in another patient. There were five cases of mild elevation in creatine kinase levels, three of which normalized over time, and two cases of mild elevation in creatinine levels.

Conclusion: This study suggests that baricitinib can effectively reduce pruritus in patients with CPUO and supports the conduct of randomized placebo-controlled trials to better elucidate the efficacy of JAK inhibitors in management of CPUO.

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治疗不明原因慢性瘙痒症的巴利替尼
背景:原因不明的慢性瘙痒症(CPUO)是一种极易使人衰弱的疾病,但缺乏有效的治疗方法。有病例报告称,Janus 激酶(JAK)抑制剂可有效治疗慢性瘙痒症,其中包括使用巴利替尼(一种选择性 JAK 1/2抑制剂)治疗的病例。 研究目的评估CPUO患者在接受巴利昔尼治疗后是否能有效减轻瘙痒。 患者和方法这是一项回顾性病例系列研究,研究对象是2022年2月至2023年8月期间在新加坡国家皮肤中心接受巴利昔尼治疗的所有CPUO患者。以0.5分的间隔记录和分析了0-10数字评分量表(NRS)的瘙痒评分。 结果:16 名 CPUO 患者(56% 为女性,平均年龄为 62.2 ± 19.7 岁)参与了分析。他们的平均慢性瘙痒持续时间为 15.4 [1-50] 年,巴利昔替尼治疗的平均随访时间为 10.2 ± 6.7 个月。巴利昔替尼治疗前后的NRS瘙痒评分中位数[IQR]分别为8.5[6.5-10.0]和3.5[1.25-5.0],瘙痒评分平均降低了4.9±2.7(p <0.0001)。除一名患者外,其他患者的瘙痒严重程度均有明显改善。除一名地中海贫血患者血红蛋白下降和另一名患者咽喉干燥外,没有其他症状性副作用的报告。有五例肌酸激酶水平轻度升高的病例,其中三例随着时间的推移恢复正常,还有两例肌酐水平轻度升高的病例。 结论这项研究表明,巴利昔尼可以有效减轻CPUO患者的瘙痒症状,并支持开展随机安慰剂对照试验,以更好地阐明JAK抑制剂在治疗CPUO方面的疗效。
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来源期刊
Dermatologic Therapy
Dermatologic Therapy 医学-皮肤病学
CiteScore
7.00
自引率
8.30%
发文量
711
审稿时长
3 months
期刊介绍: Dermatologic Therapy has been created to fill an important void in the dermatologic literature: the lack of a readily available source of up-to-date information on the treatment of specific cutaneous diseases and the practical application of specific treatment modalities. Each issue of the journal consists of a series of scholarly review articles written by leaders in dermatology in which they describe, in very specific terms, how they treat particular cutaneous diseases and how they use specific therapeutic agents. The information contained in each issue is so practical and detailed that the reader should be able to directly apply various treatment approaches to daily clinical situations. Because of the specific and practical nature of this publication, Dermatologic Therapy not only serves as a readily available resource for the day-to-day treatment of patients, but also as an evolving therapeutic textbook for the treatment of dermatologic diseases.
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