Publications

Substance P (SP) and its receptor neurokinin 1 (NK1R) are thought to be involved in the pathogenesis of chronic prurigo. Here, we assessed SP serum levels, cutaneous NK1R expression, and the effects of topical aprepitant, an NK1R antagonist, in patients with chro- nic prurigo. SP and NK1R were increased, compared with controls, in the serum and in lesional vs. non-le- sional skin of the patients, respectively. Aprepitant, in a randomized, placebo-controlled, split-sided, double- blind trial, reduced the intensity of pruritus as asses- sed by visual analogue scale by >50% from baseline to day 28 (–35.2), but so did placebo vehicle (–38.1, p = 0.76). Overall clinical scores improved significantly by day 28 in both treatment groups, with no signifi- cant difference between the 2 groups (p=0.32). Our findings imply that both SP and NK1R are involved in the pathogenesis of chronic prurigo. Parallel group- designed trials are needed to assess the efficacy of to- pical aprepitant treatment in this condition.