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Study · Case report or series · n = 1 · 2025

2 results

Effectiveness of Nemolizumab in Improving Dialysis-Associated Pruritus Refractory to Difelikefalin: A Case Report.

Mima Y, Yamamoto M, Iozumi K

Cureus2 May 2025Cited by 1 (Europe PMC)

PMID40458322 (opens in a new tab)PMCIDPMC12127145 (opens in a new tab)DOI10.7759/cureus.83367 (opens in a new tab)PepBankPUB-40458322
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Summary

Chronic kidney disease-associated pruritus (CKD-aP) is a common and distressing symptom among patients undergoing maintenance hemodialysis and is known to significantly impair quality of life. In contrast, prurigo nodularis (PN), characterized by intensely pruritic nodules, may develop as a result of persistent scratching due to chronic pruritus. While difelikefalin, a peripherally acting κ-opioid receptor (KOR) agonist, has been approved for the treatment of CKD-aP, alternative therapeutic options have not been sufficiently explored in patients who show an inadequate response. Herein, we report a case of a 74-year-old man on long-term dialysis who presented with severe CKD-aP (PP-NRS 9-10) and multiple pruriginous nodules. Although partial improvement was achieved with difelikefalin, moderate pruritus (PP-NRS 7) and residual nodules persisted. Nemolizumab, an interleukin-31 receptor α (IL-31Rα) antagonist approved for the treatment of PN, was subsequently introduced. After two doses, the patient experienced complete resolution of pruritus and marked flattening of nodular lesions. Elevated serum IL-31 levels have been reported in both PN and dialysis-related pruritus, suggesting a shared pathophysiological role of IL-31 in these conditions. The rapid and dramatic response to nemolizumab in this case supports the potential of IL-31 inhibition as a promising treatment strategy for patients with CKD-aP who are unresponsive to KOR agonists. This case represents the first report of sequential use of difelikefalin and nemolizumab for dialysis-associated pruritus and highlights the need for further studies to evaluate the efficacy of IL-31-targeted therapies in this setting.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study2

2 results from studies that gave the peptide. 2 results from people.

  1. 01HumanCase report or seriesEfficacy outcome

    In a dialysis patient, difelikefalin partially improved pruritus, but PP-NRS remained 7.

    In plain wordsIn a dialysis patient, difelikefalin partly reduced itching, but moderate itching persisted.

    Peptide
    Difelikefalin
    Outcome
    DecreasePruritus
    Study

    n = 1

    Outcome group
    Skin and hair · Skin and wound
    Studied dose
    Dose not stated

    Measurements

    PP-NRS
    7 points
    after partial improvement with difelikefalin
    PP-NRS
    9 to 10 points
    before difelikefalin (severe CKD-aP)

    Source sentences

    Summary
    Although partial improvement was achieved with difelikefalin, moderate pruritus (PP-NRS 7) and residual nodules persisted.
    1 context sentence
    Summary · context
    Herein, we report a case of a 74-year-old man on long-term dialysis who presented with severe CKD-aP (PP-NRS 9-10) and multiple pruriginous nodules.
  2. 02HumanCase report or seriesEfficacy outcome

    In a dialysis patient, residual nodules persisted after difelikefalin treatment.

    In plain wordsIn a dialysis patient, skin nodules persisted after difelikefalin treatment.

    Peptide
    Difelikefalin
    Outcome
    Direction not reportedResidual nodules
    Study

    n = 1

    Outcome group
    Skin and hair · Skin and wound
    Studied dose
    Dose not stated

    Source sentences

    Summary
    Although partial improvement was achieved with difelikefalin, moderate pruritus (PP-NRS 7) and residual nodules persisted.
    1 context sentence
    Summary · context
    Herein, we report a case of a 74-year-old man on long-term dialysis who presented with severe CKD-aP (PP-NRS 9-10) and multiple pruriginous nodules.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

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  1. Version 2Current

    28 Oct 2026, 02:03 UTC

    Study results updated

  2. Version 1

    27 Oct 2026, 16:35 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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