Nemolizumab (Nemluvio)
IL-31 receptor antagonist for refractory pruritus and prurigo nodularis
이 치료에 대해
Nemolizumab is a humanized monoclonal antibody binding to IL-31 receptor (IL-31RA). IL-31 is a central cytokine of neuroimmune pruritis, produced by T cells, dendritic cells, and keratinocytes. Blocking the IL-31-IL-31RA axis directly suppresses itch nerve (C-fiber) activation, markedly improving refractory pruritus, prurigo nodularis, and severe pruritus in atopic dermatitis. Particularly for patients with inadequate response to conventional immunosuppressive therapy, it provides innovative treatment options.
작용 기전
IL-31, a four-helix bundle cytokine produced by epithelial cells and T cells, binds IL-31 receptor complex (IL-31RA + OSMRβ). In peripheral nervous system, IL-31 receptor activation on C-fiber nerve terminals decreases desensitization, amplifying itch signal neurotransmission. Additionally, IL-31RA activation on keratinocytes promotes inflammatory cytokine (TNF-α, IL-8) production, creating a neuro-inflammatory loop. Nemolizumab, by blocking IL-31 receptor, interrupts this neuro-immune circuit and directly suppresses itch signal transmission. Particularly for neuropathic itch and chronic pruritus pathophysiology, it provides specific and effective therapeutic approach.
적응증
기대 효과
Pruritus markedly improves 2-4 weeks post-injection; most patients achieve >50% reduction in Pruritus Numerical Rating Scale (P-NRS) by 12 weeks. Particularly for refractory pruritus patients unresponsive to conventional therapy, significant QoL improvement reported.
임상 근거
위험 및 부작용
Ocular symptoms and increased infection risk not reported. Headache and upper respiratory infections mildly reported. Ocular symptoms like conjunctivitis reported less frequently than dupilumab. Pregnancy/lactation safety data limited.