Nemolizumab

How it works

It is a humanised monoclonal antibody against the interleukin-31 receptor alpha subunit, blocking IL-31 signalling, a key cytokine in the sensation of itch and in associated inflammation.

Prescribing in practice

• Live vaccines should be avoided during treatment, and patients should be assessed for active infection before initiation.
• Reactions reported with treatment include headache, peripheral oedema and hypersensitivity, which should be reviewed if they occur.
• Administered by subcutaneous injection, frequently alongside topical corticosteroids in atopic dermatitis.

Monitoring

Monitor itch and lesion response together with adverse effects such as hypersensitivity reactions and oedema.

Counselling the patient

• This treatment targets the itch pathway and is given by injection under the skin.
• Tell your healthcare team before having vaccinations, particularly live vaccines.
• Continue your emollients and any prescribed topical treatments alongside it.

Evidence & guidelines

Nemolizumab demonstrated efficacy for prurigo nodularis and atopic dermatitis in phase 3 trials (the OLYMPIA and ARCADIA programmes); follow current prescribing references for approved indications.