Itch Management: Treatments under Development

Pruritus is a symptom arising from a plethora of dermatological, neurological, and systemic conditions. The pathophysiological mechanisms involved in the transmission of acute and chronic pruritus are of high complexity and not yet fully understood. Recent research has enhanced the understanding of these mechanisms, enabling the development of novel drugs. Specifically, new therapies for inflammatory dermatoses, uremic pruritus, cholestatic pruritus, cutaneous T-cell lymphoma, and prurigo nodularis are being tested in ongoing randomized clinical trials. Compounds in development include neurokinin 1 receptor antagonists, anti-interleukin-31 receptor A antibodies, nerve growth factor inhibitors, transient receptor potential cation channel V1 antagonists, as well as κ-opioid agonists, ileal bile acid transporter inhibitors, and bile acid sequestrants. Effective treatment options for the various forms of chronic pruritus are still insufficient. Basic research studying additional pathophysiological mechanisms involved in pruritus transmission is urgently needed, as well as clinical trials testing new compounds in patients with chronic pruritus. Moreover, clinical trials including specific patients groups, such as pregnant women or children, are of the utmost importance since only few treatment options are currently approved for these patients. The aim of this chapter is to provide an overview of the drugs under development, highlighting the pathophysiological mechanisms they target.