Pruritus—it’s more than just an itch.
Pruritus can be devastating and all-consuming. While it’s defined as an unpleasant sensation that provokes the desire to scratch, we know that it can become a disabling condition for the millions who suffer from it. Certain dermatologic and systemic diseases, such as those listed below, have been known to cause pruritus for which there are few treatment options.
Read on to learn more about the different therapeutic areas we’re investigating to change the treatment landscape.
Chronic Kidney Disease-associated Pruritus (CKD-aP)
According to the National Kidney Foundation, there are over 30 million patients living with chronic kidney disease (CKD).1 It is estimated that nearly 50% suffer from some form of pruritus.2 The pathophysiology of CKD-aP is likely multifactorial, and may involve metabolic disturbances, peripheral neuropathy, a dysregulated immune system, and imbalances in the endogenous opioid system.3-5 Currently most of these patients experience inadequate relief from itching as there are no FDA-approved therapies that have demonstrated efficacy for non-hemodialysis patients.
Pruritus in Atopic Dermatitis (AD)
Atopic dermatitis (AD) is the most common chronic, pruritic inflammatory dermatosis affecting up to 12% of children and 2%-10% of adults worldwide.7,8 Chronic pruritus is one of the defining features of AD, so common that AD is often described as “the itch that rashes.” It can lead to sleep disruption, depression, anxiety, and difficulty concentrating.9
The cause of AD is multifactorial, and it is difficult to break the itch-scratch cycle. While there are many medical and non-medical treatments used to manage AD, we are investigating pruritus relief for our patients.
Pruritus in Notalgia Paresthetica (NP)
Notalgia Paresthetica (NP) is a common, but under-recognized chronic sensory neuropathy affecting the upper back. It is estimated that 8% of chronic pruritus patients suffer from neuropathic itch, including NP.10-12 One of the hallmark features of NP is chronic pruritus, which can be significantly burdensome and undermines the affected subject’s quality of life and overall well-being. The exact etiology of NP still has not been fully elucidated; however, it is thought to be caused by a sensory neuropathy due to alteration and damage to thoracic spinal nerves. The management of NP is challenging, as NP is often resistant to multiple therapies. Currently, there no FDA-approved therapies to treat NP.
- Centers for Disease Control and Prevention. Chronic kidney disease in the United States, 2021. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2021.
- Sukul N, Speyer E, Tu Cm Bieber B, et al. Clin J Am Soc Nephrol. 2019;14:673-681.
- Hiroshige K, Kabashima N, Takasugi M, Kuroiwa A. Optimal dialysis improves uremic pruritus. Am J Kidney Dis. 1995;25:413-419.
- Kimmel M, Alscher DM, Dunst R, et al. The role of micro-inflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. Nephrol Dial Transplant. 2006;21:749-755.
- Wang H, Yosipovitch G. New insights into the pathophysiology and treatment of chronic itch in patients with end-stage renal disease, chronic liver disease and lymphoma. Int J Dermatol. 2010;49:1-11.
- Centers for Disease Control and Prevention. Chronic liver disease and cirrhosis. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2018.
- Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol. 2013;132(5):1132-1138.
- Barbarot S, Auziere S, Gadkari A, et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy. 2018;73(6):1284-1293.
- Silverberg JI. Public health burden and epidemiology of atopic dermatitis. Dermatol Clin. 2017;35(3)283-289.
- Pereira MP, Luling H, Dieckhoffer A, Steinke S, Zielder C, and Stander S. Brachioradial pruritus and notalgia parasthetica: A comparative observational study of clinical presentation and morphological pathologies. Acta DV 2018;98:82-88.
- Mollanazar NK, Koch SD, Yosipovitch G. Epidemiology of chronic pruritus: where have we been and where are we going? Curr Derm Rep. 2015;4:20-29
- Situm M, Kolic M, Francheschi N, and Pecina M. Acta Clin Croat. 2018;57:721-725.