Novel drugs for the treatment of chronic pruritus

ABSTRACT

Introduction: Chronic pruritus (CP) is a multidimensional condition severely affecting the quality of life of those affected. Although a multitude of topical and systemic agents are recommended for CP of different origins, the condition often remains refractory to treatment. However, a deeper understanding of the pathophysiology of CP is leading to the development of novel antipruritic drugs.

Areas covered: This paper reviews antipruritic therapies in development by gathering data from recently published articles and clinical trials databases. Interleukin-31 antibodies and other biologics, neurokinin-1 receptor antagonists, opioid-receptor agonists/antagonists, TrkA-antagonists, and ileal bile acid transporter inhibitors are discussed.

Expert opinion: Clinical trials have rendered promising data on the antipruritic efficacy and safety of novel drugs, but further studies are necessary to enhance our understanding of the different conditions associated with CP. High-quality clinical trial data is necessary for these agents to be approved for the treatment. Basic research should be intensified to identify pathways relevant for CP and to further the development of new specific antipruritic drugs.

KEYWORDS:

• Chronic pruritus
• anti-pruritic drugs
• aprepitant
• nalbuphine
• nalfurafine
• nemolizumab
• neurokinin-1 receptor
• interleukin-31
• itch
• serlopitant

Article highlights

• Chronic pruritus is difficult to treat and often refractory to available therapies.

• New specific anti-pruritic drugs were developed because of an improved understanding of the pathophysiology of chronic pruritus.

• In recent years, clinical trials have demonstrated the anti-pruritic properties of neurokinin-1 receptor antagonists, interleukin-31 antibodies, and other biologics, janus kinase inhibitors, opioid receptor agonists/antagonists, TrkA-antagonists, and ileal bile acid transporter inhibitors.

• High-quality randomized clinical trials including patients with different conditions that induce chronic pruritus are necessary.

• Basic research is critical for identifying further relevant pathways and the development of new therapeutic targets.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This article was supported by the European Academy of Dermatology and Venereology (EADV, No. 2016–012 to MP and SST).