PRISM Study-Pruritus Relief Through Itch Scratch Modulation

Open to people ages 18 years and up

• Individuals diagnosed with generalized nodular PN, covering 2 separate body parts, and 10 or more pruriginous nodules
• Severe itch due to PN
• Age 18 years and older at the time of consent, and a life expectancy of at least 18 months.

• Pruritus due to localized PN (only one body part affected), or less than 10 nodules
• Pruritic dermatoses other than PN that were active/in need of treatment in the last 6 months, such as atopic dermatitis, bullous pemphigoid or other dermatologic conditions that in the opinion of the Investigator could confound the ability to assess PN related itch.
• Unresolved acute secondary dermatoses active (unresolved) in the last (a) 4 weeks: localized contact dermatitis, environmental exposures, superficial burns, or viral exanthems; (b) 8 weeks: skin or environmental infestations, such as scabies, lice, or bed bugs.
• Other non-dermatologic disease that could be a potential cause of concomitant pruritus (e.g., thyroid disease, celiac disease, hepatitis C virus [HCV]) must either have resolved, been successfully treated (i.e., HCV RNA negative) or must be successfully managed with stable, optimized treatment (e.g., thyroid replacement, dietary management with resolution of symptoms, respectively) for at least 3 months prior to screening
• History of a major psychiatric disorder such as bipolar disorder or schizophrenia. History of substance abuse in the last 3 years. Individuals using sedating antidepressants. Individuals using non-sedating antidepressants must be on a stable dose for a minimum of 8 weeks prior to entering the study.
• Known intolerance (GI, CNS symptoms) or hypersensitivity/drug allergy to opioids.
• Use of certain concomitant medications and treatments within a period prior to the study, or requirement for these medications during the study:
• Within 14 days prior to screening: opiates, gabapentin, pregabalin, calcineurin inhibitors, cannabinoid agonists, capsaicin, cryosurgery, topical doxepin, thalidomide or methotrexate, antihistamines (systemic or topical), and topical corticosteroids, cryotherapy.
• Within 4 weeks prior to screening: ultraviolet (UV)-therapy, exposure to any investigational medication, including placebo
• Within 3 months prior to screening: Non-insulin biologics (including monoclonal antibodies) that modify the immune system,
• Individuals taking monoamine oxidase inhibitors are excluded, as concomitant opiate use may increase the risk for serotonin syndrome.
• Individuals who have previously received dupilumab or nemolizumab are excluded
• Myocardial infarction or acute coronary syndrome within the previous 3 months, as reported by the subject.
• Individuals with prolonged QTcF

Individuals with HIV can be included if they meet the following criteria: (a) currently on a stable (> 6 months stable use) and well tolerated highly active antiretroviral therapy regimen; (b) CD4 count > 500 cells/mL; and (c) HIV ribonucleic acid (RNA) < 50 copies/mL documented for at least 6 months prior to enrollment.