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DUPIXENT® Prurigo Nodularis

Achieve a lasting change with DUPIXENT (dupilumab). Read about DUPIXENT in PN.

Prurigo nodularis – much more than a skin condition1–4

Prurigo nodularis (PN) is a distinct condition, not simply a subset of atopic dermatitis (AD).5 The chronic nature of PN is debilitating, with patients experiencing itch that is among the most severe in chronic itch conditions.1 2 in 3 patients (59/88; 67%) cite chronic itch in both nodules and inter-lesional skin*- and these painful, burning nodules can often bleed from repeated scratching, resulting in erosion and hyperpigmentation.6,7

Beyond the physical symptoms of PN, patients also experience a reduced quality of life (QoL),1,6,8 with the majority (24/39; 61.5%) reporting that pruritus disturbed their sleep to a great extent✝2 and almost half (78/171; 45.6%) having diagnosed anxiety.*1

An alternative approach to PN is needed

Patients with PN require a novel approach to help improve itch, nodules, and QoL.8,9 Only around a quarter of patients (13/49; 26.5%) report a positive response to one of the main PN treatments, topical steroids.‡9Additionally, among patients with PN, there are low levels of satisfaction with available therapies,8 with almost 60% of patients (225/396; 56.8%) reporting that they were dissatisfied with the treatments they had received in the previous 6 months.5,8

PN can impact several aspects of a patient’s life,1–4 therefore, it is important to identify people who are in need of a different treatment option.

Prurigo nodularis - driven by Type 2 inflammation10-13

Type 2 inflammation is a key driver of PN, with IL-4 and IL-13 in particular having direct and indirect effects on itch.10–15 Increased IL-4 and ll -13 signaling leads to increased activity of inflammatory mediators such as Th2, Th17 and Th22 cells, as well as eosinophils and basophils.10–13 This in turn can lead to a chronic itch-scratch cycle that leads to nodules, fibrosis and scarring.13,15–17 

Intense itch and chronic inflammation lead to disfiguring nodules and hyperpigmentation7,10-13


DUPIXENT is the first and only targeted immunomodulator to specifically inhibit IL-4 and IL-13 signaling key drivers of persistent underlying Type 2 inflammation18–20 

Interested in learning more about PN?

Visit our PN CPD educational programme

DUPIXENT offers significant improvements in symptoms and QoL vs placebo21




Nodule Clearance


Quality of Life (QOL)



Scottish Medicines Consortium (SMC) advice26 

  • Dupilumab is accepted for use within NHS Scotland. For the full guidance please follow this link for guidance for SMC 2598.  




  • Dupilumab is not recommended, within its marketing authorisation, for treating moderate to severe prurigo nodularis in adults when systemic treatment is suitable. For the full guidance please follow this link for guidance for TA - TBC


Safety Outcomes of PRIME and PRIME2


Placebo (n = 75)          DUPIXENT (n= 75)       

   Placebo (n = 82)          DUPIXENT (n= 77)

Patients with ≥ 1 TEAE        42 (56.0)                       49 (65.3)         38 (46.3)                       42 (54.5)
Patients with and SAEa          5 (6.7)                           3 (4.0)           1 (1.2)                             2 (2.6)
Patients with ant treatment-emergent SAE          6 (8.0)                           5 (6.7)           2 (2.4)                           2 (2.6)
Deaths              0                                    0                0                                   0
Patients with TEAE leading to treatment discontinuationb          2 (2.7)                               0           1 (1.2)                                0
TEAEs reported in ≥ 5% of patients in any treatment group (MedDRA PT), n (%)              
Nasopharyngitis          3 (4.0)                           4 (5.3)               0                               2 (2.6)
Headache          4 (5.3)                           4 (5.3)           5 (6.1)                           4 (5.2)
COVID-19          4 (5.3)                               0           1 (1.2)                            1 (1.3)
Neurodermatitis          6 (8.0)                           1 (1.3)           3 (3.7)                          2 (2.6)
TEAE groups of interest, n (%)
Herpes viral infections (HLT)c              0                                   0               0                               4 (5.2)
Skin infections (excluding herpetic infections)d          7 (9.3)                           2 (2.7)           5 (6.1)                           4 (5.2)
Conjunctivitis (narrow)e          2 (2.7)                           2 (2.7)               0                               3 (3.9)
Coronavirus infections (HLT)f          4 (5.3)                           1 (1.3)           3 (3.7)                          1 (1.3)
COVID-19          4 (5.3)                               0           1 (1.2)                           1 (1.3)
Asymptomatic COVID-19              0                                    0           2 (2.4)                       
COVID-19 pneumonia              0                                1 (1.3)               0                                   0

aConsidered unrelated to the study intervention except for two events of sepsis and mesenteritis, experienced by one placebo-treated patient in PRIME. bIn PRIME, one event each of Hodgkin’s disease and neurodermatitis (MedDRA PTs), considered unrelated to the study drug. In PRIME2, one event of urticaria. cHerpes viral infections (HLT) includes MedDRA PTs oral herpes, herpes zoster, ophthalmic herpes zoster and genital herpes simplex. None of these TEAEs was severe, and all patients recovered with corrective treatment while continuing dupilumab. dSkin infection TEAEs (excluding herpetic infections) were identified based on blinded medical review of all reported TEAEs identified as possible skin infections using CMQ30067. This search included MedDRA PTs under HLGT Skin and subcutaneous tissue infections and infestations, all MedDRA PTs under HLT Skin structures and soft tissue infections, all MedDRA PTs of ‘wound infection’ and MedDRA PTs of chalazion, hordeolum and skin papilloma. eConjunctivitis (narrow term) includes MedDRA PTs conjunctivitis, conjunctivitis bacterial, conjunctivitis viral, conjunctivitis adenoviral, conjunctivitis allergic and atopic keratoconjunctivitis. fCoronavirus infections (HLT) include MedDRA PTs COVID-19, asymptomatic COVID-19 and COVID-19 pneumonia. COVID-19, Coronavirus Disease 2019; HLGT, High-Level Group Term; MedDRA, Medical Dictionary for Regular Activities; PT, Preferred Term. Yosipovitch G, et al. Nat Med. 2023;29:1180-1190.


Dosing and administration18 

Dupixent is indicated for the treatment of adults with moderate-to-severe PN who are candidates for systemic therapy.

Administration considerations in PN‡  

  • Rotate injection site with each injection  
  • Provide proper training to patients and/or caregivers on the preparations and administration of DUPIXENT prior to use, according to the Instruction for Use   
  • Consider completing all age-appropriate vaccinations as recommended by current immunisation guidelines prior to initiating treatment with DUPIXENT  
  • If an every-2-week dose is missed, instruct the patients and/or caregivers to administer the injection within 7 days from the missed dose and then resume their original schedule. If the missed dose is not administered within 7 days, instruct the patients and/or caregivers to wat util the next dose on the original schedule  
  • If an every-4-week dose is missed, instruct the patients and/or caregivers to administer the injection within 7 days from the missed dose and then resume their original schedule. If the missed dose is not administered within 7 days, instruct the patients and/or caregivers to administer  the dose, starting a new schedule based on this date   

Select the injection site18:   

  • Stomach (except for 5cm area around navel)   
  • Thigh   
  • Outer upper arm (caregiver only)   
  • Do not inject into skin that is tender, damaged, bruised, or scarred   
  • Do not inject through clothes   
  • Wash hands and clean the injection site with an alcohol wipe before injecting—do not touch the injection site again or blow on it  

Before administering DUPIXENT read complete Instructions for Use.

DUPIXENT offers 2 administration options

DUPIXENT pre-filled syringe18:

Pen Dupixent
  • Manual control of injection speed 
  • Finger grip for comfort 
  • Visual confirmation of injection delivery 
  • Needle shield 
  • Easy-to-carry format 
  • Available for use in patients aged 6 months and up by a healthcare provider or caregiver 

DUPIXENT pre-filled pen18:

Dupixent pen
  • Single-press auto-injector 
  • A clear, 2-step process 
  • Visual and audible feedback  
  • Hidden needle 
  • Compact and convenient to carry 


Dupixent Adults Administration

Dupixent for Atopic Dermatitis

Learn more about the efficacy, safety and dosing of Dupixent for patients living with Atopic Dermatitis (AD).


MAT-XU-2400765 (v2.0) Date of Preparation April 2024