FDA Approval of Dupilumab: Thoughts from Dr. Lal

The U.S. Food and Drug Administration recently approved dupilumab as the first and only treatment for adults with prurigo nodularis (PN). 

This is welcome news to providers and their patients, who know the heavy burden of this debilitating disease.

Double board-certified dermatologist, Karan Lal, DO, MS, has weighed in on this latest approval. Dr. Lal looks after pediatric and adult patients and forms part of LiVDerm’s esteemed faculty. He explains why he believes dupilumab is encouraging for dermatologists. 

Dr. Lal states that PN is much more common than often believed and reports seeing the condition in a significant portion of his patient population.

Of all the cutaneous itch diseases, Dr. Lal considers PN to be the one that has the most psychological burden.

“These are people that have such significant itch that they literally learn how to survive on many different medications. A lot of them really have a decreased quality of life. Some of them cannot sustain a job because they are so itchy.”

For a long time, providers have used topical steroids and phototherapy to treat PN. And while some see success with these treatments, they are not always ideal. Topical steroids can stop working over time as people become used to them, and phototherapy is time-consuming, often requiring two to three appointments per week. 

Having already revolutionized the treatment landscape for other conditions such as atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyposis, this latest approval is another significant step forward for everyone involved.

Dr. Lal adds, “I think it’s really important to realize that, compared to placebo, three times as many patients had a clinically meaningful reduction in itch in both of the PRIME1 and PRIME2 studies, and that’s a lot.” 

Looking to the future, Dr. Lal mentions,

“It’s one of those drugs that we know works so well for itch and the inflammatory aspects of it, that we really feel safe tying it in other things…For atopic dermatitis, it’s [dupilumab] FDA-approved for six months and older. So I think the net of conditions that we are going to be treating with dupilumab is just going to get larger over time.” 

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