Prurigo Nodularis PaTient-Reported BurdEn of SicKness (PN TREK): A Cross-Sectional Survey of Patient-Reported Burden of Disease in Patients with PN from the US

Introduction: This study assessed the comprehensive disease burden, the correlation among different patient-reported outcome measures (PROMs), and patient-reported treatment satisfaction with non-biologic agents in adult patients with prurigo nodularis (PN) in the United States. Methods: A patient survey was conducted in the United States from June 30 to October 6, 2022, in patients with a self-reported diagnosis of PN. The survey included different PROMs assessing the symptoms and impacts of PN. The t test, chi-square test, Fisher's exact test, Spearman correlation, and Kendall correlation analysis were performed where applicable. Results: A total of 132 patients participated in the survey. Approximately 46%, 34%, and 20% of patients reported a worst itch-numeric rating scale (WI-NRS) score of >= 7, 3-6, and 0-2, respectively. Assessment of PROMs revealed that patients with a WI-NRS score of >= 7 (vs. 0-2) experienced more severe skin pain, neurological pain, greater negative impacts on quality of life (QoL), sleep disturbance, mental health, and work productivity and activity impairment (WPAI), as well as higher health care resource utilization (HCRU) (all p < 0.001). The proportion of patients satisfied with non-biologic treatment was significantly lower in patients with WI-NRS >= 7 (23.0% vs. 80.8% in WI-NRS 0-2). WI-NRS, Patient Global Impression of Severity (PGIS), average itch-NRS, and Dermatology Life Quality Index (DLQI) were strongly positively correlated (r >= 0.5) with each other and negatively correlated with Patient Global Assessment (PtGA) (r < - 0.5), while the number of nodules had weak correlations (absolute r < 0.3) with all PROMs except PGIS (r = 0.403) and PtGA (r = - 0.327). Conclusion: In patients with PN, severe itching is associated with an increased symptom burden, greater disease impact, along with reduced satisfaction with non-biologic treatments. Additionally, the number of nodules alone may not adequately describe disease severity in patients with PN.