Scientists are developing an injection that could reduce the itch caused by eczema for months at a time, according to research due to be published in the British Journal of Dermatology.

Atopic eczema, a skin disorder linked to allergies, asthma and hayfever, is very common, affecting at least one in five children and often lasting into adulthood. The main symptom is itch, which can be severe, and the scratching in response to the itch worsens the eczema, prevents sleep, causes skin infection and can greatly reduce the patient’s quality of life.

Now scientists have discovered a drug that could be given as a single injection, targeting the mechanisms in the body that cause the itch sensation.

Patients with eczema produce higher levels of a protein in the blood and in affected skin called interleukin-31 (IL-31), which is thought to be responsible for skin itching, also known as pruritus. IL-31 binds to IL-31 Receptor A (RA) on the cells and then transfers the signals into the cells.

Antibodies are proteins produced by the immune system in response to ‘foreign’ substances which may be harmful to the body. Antibodies bind themselves to the substances so that they can be recognised by cells that seek out and destroy them. In this study, this characteristic feature, specific binding of antibodies to the substances, is utilised as a drug.

Researchers from Japan tested whether an antibody called CIM331, when injected into the body would bind itself to IL-31 RA, thereby reducing its ability to cause itching.

Volunteers, who were either eczema patients or people without eczema, received either an injection of a placebo or of CIM331. Each person receiving CIM331 received just a single injection but the dosages varied from 0.003mg/kg to 3mg/kg.

In the eczema patients, scores on a scale used to measure pruritus were reduced by between 24 and 33 per cent (depending on the dose given) one week after treatment with CIM331, compared to a nine per cent reduction in the placebo group.

After four weeks, the reduction in the pruritus score was between 45 and 50 per cent in the CIM331 group compared to 20 per cent in the placebo group. CIM331 increased sleep and reduced the need for a cream used to treat eczema called hydrocortisone butyrate.

These positive results were maintained for the full eight weeks that patients were monitored for. None of the volunteers suffered from serious adverse events (side effects).

The authors conclude that a single injection of CIM331 decreased pruritus and sleep disturbance in eczema patients, and that CIM331 may become a novel treatment option for atopic eczema by inhibiting IL-31.

Nina Goad of the British Association of Dermatologists said: “With eczema, if you can break the itch-scratch cycle, then half the battle is won. Itch is not only a deeply unpleasant effect of eczema, but scratching actually makes the disease worse. Reducing the itch will allow the skin to heal, help patients to sleep better and to get back control of their lives.

“The mainstay of current treatment involves creams applied to the skin, many times a day, which can be messy and impractical. The study showed that patients using the drug did not need to rely so much on topical medications.

“The drug is not ready to go on the market yet, but in terms of first steps, this is a very positive one.”

Eczema has no single known cause but defects in the body’s immune system (which normally fights off disease) and the skin ‘barrier’ (the protection provided by the skin’s outermost layer) are both thought to play a part.

Ends

For more information, please contact: British Association of Dermatologists, Communications Team or comms@bad.org.uk, Website: www.bad.org.uk

Study details: British Journal of Dermatology: The first trial of CIM331, a humanized anti-human IL-31 receptor A antibody, for healthy volunteers and patients with atopic dermatitis to evaluate safety, tolerability and pharmacokinetics of a single dose in a randomised, double-blind, placebo-controlled study. O. Nemoto,, M. Furue, H. Nakagawa, M. Shiramoto, R. Hanada, S. Matsuki, S. Imayama, M. Kato, I. Hasebe, K. Taira6, M. Yamamoto, R. Mihara, K. Kabashima, T. Ruzicka, J. Hanifin andY. Kumagai. DOI: 10.1111/bjd.14207
The accepted article version in the BJD can be viewed online: http://onlinelibrary.wiley.com/doi/10.1111/bjd.14207/pdf
It will appear in the hard copy version of the journal in February 2016.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. For further information about the charity, visit www.bad.org.uk

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The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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