Chronic Nodular Prurigo: A European Cross-sectional Study of Patient Perspectives on Therapeutic Goals and Satisfaction
Manuel P. Pereira, Claudia Zeidler, Joanna Wallengren, Jon Anders Halvorsen, Elke Weisshaar, Simone Garcovich, Laurent Misery, Emilie Brenaut, Ekin Şavk, Nikolay Potekaev, Andrey Lvov, Svetlana Bobko, Jacek C. Szepietowski, Adam Reich, Agnieszka Bozek, Franz J. Legat, Martin Metz, Markus Streit, Esther Serra-Baldrich, Margarida Gonçalo, Michael Storck, Teresa Nau, Vincent Hoffmann, Sabine Steinke, Ina Greiwe, Martin Dugas, Matthias Augustin, Sonja Ständer
Chronic nodular prurigo is characterized by recalcitrant itch. Patient perspectives on therapeutic goals, satisfaction with therapy and efficacy of therapeutic regimens for this condition are unknown. This questionnaire study examined these issues in 406 patients with chronic nodular prurigo from 15 European dermatological centres. Improvements in itch, skin lesions and sleep were the most important goals. Emollients, topical corticosteroids and antihistamines were the most frequently used treatments, while a minority of patients were prescribed potent medications, such as systemic immunosuppressants and gabapentinoids. Most patients were not satisfied with their previous therapy (56.8%), while 9.8% did not receive any therapy despite having active disease. A substantial number of respondents (28.7%) considered none of the therapeutic options effective. Although chronic nodular prurigo is a severe disease, most patients were not treated with potent systemic drugs, which may contribute to the high levels of dissatisfaction and disbelief in available therapies. Specific guidelines for chronic nodular prurigo and the development of novel therapies are necessary to improve care.
Chronic prurigo is a highly impairing itchy skin disease, which is difficult to treat. This questionnaire study of 406 patients with active disease at 15 centres across 12 European countries revealed that improvements in itch, skin lesions and sleep are the most important goals for patients. Most patients were not satisfied with their therapy. Almost 10% of patients surveyed did not receive any treatment despite having active disease, while only a minority received potent medication to treat their chronic prurigo. In general, patients with chronic prurigo considered that they were not adequately treated and experienced high levels of dissatisfaction with their therapy.