Sorry but I am still just returning to my somewhat (oldself) new normal, after my unintended collision w/ COVID...
Anyways, I am sure that you have at least heard of PRURITUS; even if somehow you remain yet to experience its unpleasantness...
A new drug has recently shown to be of some benefit for mastering the "ITCH" if indeed such a thing is entirely possible...?
I say that because, even tho' my Dx is Post ET / MF - I did periodically suffer from intense bouts of PRURITUS too...
However, in my case, it all but disappeared completely upon my commencement of RUX'... Almost... for some reason, every now & then, smaller events do still manage to antagonise me...
This article, may provide some hope for those out there unable to benefit from the "RUX'" Escape...
The SAMPLE of patients, is VERY small... However the results appear promising too... My recommendation is to Download & read the entire Paper...
Cited in the Reference below is the DOI: doi: 10.3324/haematol.2022.281639. Just copy & paste into your browser...
Best wishes
Steve
Omalizumab alleviates pruritus in myeloproliferative neoplasms
Anna Ravn Landtblom et al; 2023,
Chronic pruritus is common in patients with myeloproliferative neoplasms (MPN), particularly in polycythemia vera (PV). Pruritus is typically of aquagenic character, where an intense pruritus is evoked by skin contact with water, but may also include a stinging, burning, or tingling sensation. In contrast to urticarial disease, aquagenic pruritus is typically not associated with visible skin changes. It is most commonly localized centrally on the body: thorax, abdomen, back and proximal extremities.1 Pruritus in MPN may also be more generalized and be triggered by other factors than water contact. Pruritus is prevalent in PV, where 31-69% of patients suffer from chronic pruritus, and 15% report aquagenic pruritus of unbearable intensity.1 Pruritus also occurs in other subtypes of MPN but the prevalence and severity is not as well characterized.2 Chronic pruritus in MPN may result in a substantially compromised quality of life and lead to anxiety and depressive symptoms, as well as water-avoiding behaviors with negative effects on personal hygiene and social interaction.3,4
Several treatment options have been reported to alleviate MPN-related pruritus, including hydroxyurea, interferons, ruxolitinib, normalization of hematocrit by venesection, antihistamines, SSRI (paroxetine and fluoxetine), narrowband UV-B light, psoralen UV-A light (PUVA), and alkalization of bathing water.5 Interferons are described to have better effect against pruritus than hydroxyurea with a reported efficacy of 81%.6 JAK2 inhibition with ruxolitinib has also been reported to reduce pruritus.7 Interestingly, SSRI has been shown to alleviate symptoms in eight of ten described patients.8 Despite numerous alternatives, MPN-related pruritis refractory to current treatments remains a clinical challenge. In addition, pruritus may occur in younger individuals with low risk of thrombosis, where cytoreduction is not otherwise indicated, or in patients with intolerance to available cytoreductive therapies. Therefore, there is a great clinical need to find novel approaches to alleviate refractory MPN-related pruritus.
Omalizumab is a humanized monoclonal immunglobulin E (IgE) antibody, that binds with high affinity to free IgE and prevents receptor binding. Omalizumab is Food and Drug Adminstration-approved for refractory asthma, nasal polyps and chronic idiopathic urticaria. Here we describe a series of patients with MPN that were treated with omalizumab for severe pruritus.
We describe seven patients with intense chronic pruritus related to PV and essential thrombocythemia (ET) treated with omalizumab at the Karolinska University Hospital. The diagnoses of PV and ET were defined according to the World Health Organization 2016 criteria. The data presented were retrieved from medical charts. Complete resolution was defined as patients describing the pruritus as being completely gone, partial resolution as patients describing the pruritus being clearly reduced but not entirely gone.
REFERENCES
Landtblom, Anna Ravn et al; 2023. Omalizumab alleviates pruritus in myeloproliferative neoplasms
Haematologica. 2023 Jul 1; 108(7): 1968–1971.
Published online 2023 Jan 26. doi: 10.3324/haematol.2022.281639
