Updates in Itch Therapy

On the third day of Spring Dermatology Week 2024, Brian Kim, MD, MTR, a professor of dermatology at Icahn School of Medicine at Mount Sinai in New York, NY, discussed breakthroughs in itch therapy during his presentation, “Breakthroughs in Itch Therapy.”

He outlined the objectives of the talk, which included understanding the mechanisms of itch, reviewing recent treatments for conditions like atopic dermatitis and prurigo nodularis, and highlighting emerging therapeutics for these conditions, as well as for notalgia paresthetica.

Dr Kim explained that the sensation of itch involves specific nerve fibers called unmyelinated C fibers within the somatosensory nervous system. When histamine or other factors activate these fibers, they send signals to the spinal cord and eventually to the brain, resulting in the perception of itch. Scratching alleviates itch by stimulating mechanical sensory nerves preventing the itch signals from reaching the brain.

He discussed the role of various factors, including histamine, IL-31, and cytokines, in mediating itch, particularly in conditions like atopic dermatitis and prurigo nodularis. Dr Kim highlighted the efficacy of monoclonal antibodies targeting IL-31 receptors in clinical trials for these conditions, with potential US Food and Drug Administration approval expected soon.

Additionally, Dr Kim discussed the role of cytokine receptors and Janus kinases (JAK) in itch modulation. He mentioned the success of JAK inhibitors like baricitinib and tofacitinib in treating itch associated with atopic dermatitis, emphasizing their potential as neuromodulatory agents.

Furthermore, Dr Kim explored the involvement of the opioid receptor system in itch modulation. He discussed a phase 2 clinical trial using a kappa opioid receptor agonist for notalgia paresthetica, which showed significant reduction in itch scores compared to placebo, suggesting the potential of targeting this system for itch relief.

In conclusion, Dr Kim highlighted the ongoing translational revolution in itch therapy, where agents originally developed as anti-inflammatory drugs are now recognized for their neuromodulatory properties in treating itch. He emphasized the importance of understanding the underlying mechanisms of itch and conducting translational research to develop effective therapeutics for various chronic itch conditions.

For more meeting coverage, visit the Spring Dermatology Week 2024 newsroom.

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Reference
Kim B. Breakthroughs in itch therapy. Presented at: Dermatology Week; May 8–11, 2024; Virtual.