The following is a summary of “Baricitinib for Prurigo Nodularis: A Pilot Study on Efficacy and Safety,” published in the May 2024 issue of Dermatology by Pongcharoen, et al.
Managing prurigo nodularis (PN) effectively involves breaking the itch-scratch cycle and facilitating lesion healing. For a study, researchers sought to evaluate the efficacy of baricitinib, an oral JAK1/2 inhibitor, in treating PN.
In the prospective pilot study, 12 patients with moderate to severe PN received oral baricitinib at a dosage of 4 mg/day for 12 weeks. The primary objective was to assess baricitinib’s efficacy using the numeric rating scale (NRS) for pruritus, NRS sleep score, a 5-point investigator’s global assessment (IGA) scale, dermatology life quality index (DLQI), and nodular lesion count at weeks 0, 1, 2, 4, 8, and 12. Additionally, NRS pruritus and sleep scores were assessed via phone on days 2 and 4 post-treatment.
Baricitinib treatment led to statistically significant improvements in mean NRS pruritus and sleep scores, evident as early as day 2 (57.7% change from baseline, P < 0.001; and 34.7% change from baseline, P < 0.001, respectively), with consistent decline thereafter. Nodular lesion evaluation showed a significant reduction starting from week 2 (mean difference of 37.08 from baseline, P < 0.001). Analysis of other endpoints, including mean DLQI and IGA scores, demonstrated substantial improvement at all time points compared to baseline. However, the study’s limitation of a small sample size should be acknowledged, influencing result interpretation and generalizability.
The study highlighted the potential of baricitinib in PN treatment by eliciting a rapid clinical response. Larger and longer randomized controlled trials were warranted to ascertain baricitinib’s effectiveness, longevity, and safety in managing PN.
Reference: hindawi.com/journals/dth/2024/9619586/