Emerging drugs for the treatment of chronic pruritic diseases

ABSTRACT

Introduction

Chronic pruritus is non-histaminergic and mediated through a complex interplay of peripheral and central immune and neural pathways. Significant developments in the understanding of chronic pruritus have emerged and paved the way for new, emerging therapies.

Areas covered

This review details the emerging drug landscape for chronic pruritus treatment, focusing on monoclonal antibody agents that target key cytokines and their receptors as well as small molecule agents that inhibit mediators of the immune and neural pathways. The article provides background regarding the currently available therapies and the rationale for the development of new agents based on the current market and recent scientific developments.

Expert opinion

Identification of new targets along neuroimmune itch pathways has allowed for the development of targeted drugs which can be utilized for effective therapy. As we enter a new era of chronic itch treatments, we face exciting prospects and challenges.

KEYWORDS:

• Pruritus
• chronic itch
• clinical trials
• monoclonal antibodies
• biologics
• small molecule agents
• JAK inhibitors

Article highlights

• Monoclonal antibodies and small molecule agents make up the majority of the emerging drug market for chronic pruritus.

• Agents that target the neuroimmune itch pathways and have shown promise in clinical trials are highlighted.

• While immune adverse effects have been noted with some agents, many have shown favorable safety profiles and their use in chronic itch is promising.

Declaration of interest

G Yosipovitch is Scientific Board Member of Menlo, Trevi, Sanofi, Regeneron, Galderma, Pfizer, Novartis, Bayer, Kiniksa, and Eli Lilly. G Yosipovitch has received research support by Pfizer, Sun Pharma, Leo, Menlo, Novartis, Kiniksa. The authors have no other 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 apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they work for a company that is developing anti-inflammatory and anti-pruritic small molecules. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.