Nemluvio (nemolizumab-ilto) is a recently FDA-approved medication that offers relief for adults suffering from prurigo nodularis, a chronic skin disorder characterized by intense itching and the formation of raised, thickened nodules.
Nemluvio: Treatment Uses, Proper Dosage, Possible Side Effects
Approved for use in 2024, Nemluvio works by targeting the interleukin-31 (IL-31) receptor, a key driver of inflammation and itching in the skin. As a targeted treatment, Nemluvio presents a promising new option for patients who have struggled to find relief from this debilitating condition.
Treatment Uses of Nemluvio
Nemluvio is specifically indicated for the treatment of prurigo nodularis in adults. This condition, while not life-threatening, significantly impacts the quality of life for those affected. The primary symptom of prurigo nodularis is intense itching (pruritus), which can lead to excessive scratching and skin damage. Other symptoms may include the development of firm, raised bumps or nodules on the skin. These nodules often appear in areas such as the arms, legs, and back, and can become painful or prone to infection due to repeated scratching.
By blocking the IL-31 receptor, which plays a pivotal role in the inflammatory process and itching sensation, Nemluvio helps to alleviate these distressing symptoms. This mechanism of action makes it a first-line biologic therapy for those who do not respond to other treatments, including topical therapies or systemic medications like corticosteroids.
Proper Dosage and Administration
Nemluvio is administered subcutaneously (under the skin) and requires reconstitution before use. The specific dosage varies depending on the patient's weight.
For adults weighing less than 90 kg, the recommended dosage starts with an initial dose of 60 mg, which is administered as two separate 30 mg injections. After the initial dose, the maintenance dose is 30 mg every 4 weeks.
For adults weighing 90 kg or more, the initial dose is the same (60 mg), but the maintenance dose is 60 mg every 4 weeks.
Nemluvio is delivered through a single-dose prefilled dual-chamber pen, which contains both the lyophilized powder (30 mg) and a diluent. Before the injection, the medication must be reconstituted. It is essential that the reconstituted solution is used within 4 hours, after which any remaining solution should be discarded. Patients are typically trained by a healthcare provider to administer the injections themselves, once they have received proper instruction.
It is important to avoid injecting Nemluvio into areas with bruises, scars, or open wounds. The injection should be performed in areas like the upper thighs or abdomen, excluding a 2-inch area around the navel.
Possible Side Effects
Like any medication, Nemluvio can cause side effects, although most people tolerate it well. The most common adverse reactions include:
Headache
Atopic dermatitis
Eczema (nummular eczema)
These side effects are typically mild and transient. However, in some cases, more serious reactions can occur. For example, hypersensitivity reactions, including facial angioedema (swelling), may be experienced. In such cases, treatment should be discontinued immediately, and appropriate medical intervention should be sought. Patients with known allergies to nemolizumab-ilto or any of its excipients should not use Nemluvio.
Patients using Nemluvio should also be cautious about live vaccinations, as the medication can affect the immune system. It’s essential to complete all vaccinations as recommended before starting Nemluvio. The drug may also interact with other medications that are metabolized through the cytochrome P450 system, so dosage adjustments for drugs like warfarin and cyclosporine may be required.
Nemluvio provides an innovative solution for managing prurigo nodularis, offering hope to patients whose conditions have not improved with conventional treatments. By targeting the underlying mechanism of inflammation and itching, it offers long-term relief and significantly improves the quality of life for individuals affected by this challenging condition. As with any treatment, it is essential to follow the recommended dosage, stay informed about potential side effects, and consult a healthcare provider regularly to ensure the best outcomes.
