Prioritizing Itch and Sleep Improvement in Atopic Dermatitis

“It's very important to understand that sleep abnormalities are an essential part of the severity of itch in patients with atopic eczema, and we're better understanding the mechanisms of abnormal sleep in these patients. There are some new technologies to assess itch with devices such as the atom accelerometer. There are infra-Wi-Fi techniques detecting radio signals without any device on the patients that are installed in the room that can measure the scratching and itch at nighttime,” said Gil Yosipovitch, MD, in an interview at the 2024 Revolutionizing Alopecia Areata, Vitiligo, and Eczema (RAVE) Conference in Chicago, Illinois.¹

Yosipovitch, professor and Stiefel Endowed Chair of medical dermatology of the Dr. Phillip Frost department of dermatology at the Miller School of Medicine at the University of Miami and director of the Miami Itch Center, presented pearls on the importance of assessing itch and sleep in patients with atopic dermatitis.

In his interview, Yosipovitch also discussed atopic dermatitis therapeutics in the pipeline that he is looking forward to and that were discussed at RAVE.

“There are developments on disease modification, like the OX40 target that seems to be very exciting. There are new drugs that will be launched this year, including nemolizumab which deals mainly with itch, a very robust anti-itch effect that targets the IL-31 receptor. There is also lebrikizumab, which is an IL-13 antibody that seems to be, again, very potent for itchy patients,” said Yosipovitch.

Dermatology Times also caught up with Yosipovitch about his recent publication on the association of systemic B-Type natriuretic peptide (BNP) levels with itch intensity ratings related to chronic itch. Yosipovitch and his colleagues found multiple examples of evidence suggesting that high levels of BNP can induce itch through central pathways in the spinal cord of mice. The study authors found that increased systemic BNP levels and NT-proBNP correlated to itch severity overall in chronic itch patients.²

Yosipovitch and his colleagues concluded that their evidence shows that high levels of BNP can induce itch through central pathways in the spinal cord of mice, and that certain concentrations of systemic BNP can access the spinal cord to stimulate central itch sensory pathways.

“We also presented some data on a new biomarker that we think is very helpful in patients with itch, not just with atopic eczema, but it clearly is shown to be associated with atopic eczema. It's called brain natriuretic peptide, and we feel that it may be used in a clinical setting to assess the severity of itch in response to treatment with anti-itch drugs,” said Yosipovitch in his interview at RAVE.

References

1. Yosipovitch G. State of the art in assessing itch and sleep in atopic dermatitis. Presented at: 2024 Revolutionizing Alopecia Areata, Vitiligo, and Eczema Conference; June 8-10, 2024; Chicago, IL.

2. NattkemperLA, Kim BS, Yap QV, Hoon MA, Mishra SK, Yosipovitch G. Increased systemic levels of centrally acting B-type Natriuretic Peptide are associated with chronic Itch of different types. J Invest Dermatol. Published online March 22, 2024. doi:10.1016/j.jid.2024.02.026