Patient preferences for prurigo nodularis treatment: a discrete choice experiment

Characterized by severe pruritus and nodular lesions, prurigo nodularis (PN) is a chronic, inflammatory skin condition that significantly impairs quality of life. Few treatments are specifically approved for PN, and limited evidence exists on patient needs and preferences.

To quantify treatment preferences among adults with moderate to severe PN.

An online discrete choice experiment was administered to 150 adults in the UK (N = 75) and US (N = 75) including 7 attributes: onset of itch reduction, onset of skin lesions/nodules reduction, probability of no itch at 16 weeks, probability of skin healing at 16 weeks, adverse events, special warnings, and administration frequency. Data analysis was conducted using random parameter logit models.

Onset of itch reduction was the most important attribute, with a conditional relative importance (CRI: 36.91) 7.4 times greater than onset of skin lesions/nodules reduction (CRI: 5.02) and nearly twice as important as the probability of achieving skin healing (CRI: 22.05) or no itch at 16 weeks (CRI: 20.54). Attributes related to safety and administration frequency had CRIs between 6.3 and 3.9.

Patients with PN prioritize rapid itch relief over long-term outcomes and safety considerations, underscoring the importance of incorporating patient preferences into clinical and payer decision-making.