A NEW analysis of two major clinical trials suggests that dupilumab may provide broader benefits for patients with prurigo nodularis (PN) than previously recognised, even among those who do not achieve the most stringent treatment goals.
The findings examined outcomes from the LIBERTY-PN PRIME and PRIME2 studies, which evaluated dupilumab in adults with PN, a chronic inflammatory skin disease marked by intensely itchy nodules that can severely affect quality of life.
Earlier trial results showed that after 24 weeks of treatment, 35.3% of patients receiving dupilumab achieved a combined “optimal response”, defined as at least a four-point reduction in itch severity alongside clear or almost clear skin, compared with 8.9% of patients given placebo.
However, researchers wanted to understand whether patients who failed to meet this strict benchmark still experienced meaningful clinical improvements.
The new analysis focused on 99 dupilumab-treated patients and 144 placebo-treated patients who had not achieved the optimal response by week 24. Despite missing the primary endpoint, many patients taking dupilumab reported substantial improvements across several measures.
Dupilumab Benefits Extend Beyond Strict Trial Endpoints
More than 61% of dupilumab-treated patients experienced a clinically meaningful improvement in quality of life, measured by at least a nine-point reduction in the Dermatology Life Quality Index (DLQI). In addition, 55.8% rated their disease severity as “none” or “mild” on the Patient Global Impression of Severity scale.
Skin healing also improved significantly. Over half of patients treated with dupilumab achieved at least 75% healing of lesions, while nearly 46% met a less stringent combined endpoint involving improvements in both itch and skin appearance. All outcomes were statistically significant compared with placebo.
Quality of Life Gains Highlight Broader Treatment Impact
The authors say the findings highlight the importance of looking beyond rigid trial endpoints when assessing treatment success in PN. Patients who do not reach complete or near-complete clearance may still gain substantial relief from itching, healing of lesions, and improvements in daily functioning and wellbeing.
Researchers concluded that the data support continued dupilumab treatment in patients with partial responses and underline the need for a long-term “treat-to-target” strategy in managing prurigo nodularis.
Reference
Ständer S et al. Dupilumab Treatment Provides Multidimensional Benefits in Patients with Prurigo Nodularis. Dermatol Ther (Heidelb). 2026; DOI: 10.1007/s13555-026-01777-z.
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