Chronic Itch? Arthritis Drug is Potential New Therapy Fighting Itch


itching and scratching consumed Karin
burgers life until she met dermatologist dr. Brian Kim’s he was scratched he
could bleed I would wake up in the morning and there’d be blood on the
sheets because I had scratched during the night it wasn’t even aware of it
but he would scratch until you just bled her quality of life the two years before
was debilitating and at times beyond what words can describe this is what she
said she did all the time scratch herself as the itching was
unbearable unrelenting and uncontrollable it never went away
I started getting rashes on my back the end up spreading everywhere and she said
no one could diagnose the cause Karen went to specialists dermatologists
allergist she tried every test and cream they offered at over 200 different tests
on my back so I went to the whole elimination
process to change my diet changed everything I wore changed soaps shampoos
everything cuz just a case that was part of the problem and still nothing worked
no relief and it only got worse eventually she was sent to see dr. Kim
it became overwhelming so when I before IB got on the medication it became so
overwhelming tonight I didn’t know what I was going to do next that medication
is the remedy Kim offered he’s able to help Karen and some other chronic itch
patients who have a type of itch from an unknown cause a condition called
idiopathic pure itis for Karen Kim prescribes the anti-inflammatory drug
xeljanz a rheumatoid arthritis medication it’s a potential new therapy
for chronic itch while off-label for itching Karen said
she didn’t have issues with insurance coverage because she has rheumatoid
arthritis it was just a matter of switching her arthritis medications to
xeljanz drug called tofacitinib its brand name is xeljanz and it is known
this jack enzyme that it blocks was known to be a great target as an
anti-inflammatory agent so as a result this drug is used for rheumatoid
arthritis which is an inflammatory disease of the joints Kim is co-director
of the Center for the study of itch at Washington University School of
Medicine in st. Louis the research teams showed that sensory neurons in mice and
people are activated by the immune signaling molecule called interleukin 4
or il for the molecule stimulates a key protein in nerve cells a critical
component of chronic itching this led to a small study providing proof that the
medication xeljanz works for chronic itch and the aha moment was that AA jock
doesn’t just work in immune cells but it’s very important in the nervous
system so then the focus shifted for us that oh this drug could actually be a
neuromodulatory drug not an immunomodulatory drug in the study
patients on average experienced 80% improvement after two years of suffering
Karen’s life changed within a matter of days once I started taking it within 24
hours the the intensity of the itch had started to subside it was like I got a
shower that morning I was like I’m not as bad that’s interesting still all
broken out still you know still scratchy up places but within two or three days
it was like it was subsiding it was like watching it go away and within a week I
was fairly clear but within two weeks I was completely clear I was like I was
back to my normal skin then 15% of people suffer from chronic itch most
often caused by inflammatory conditions like eczema and psoriasis or associated
with cancers and nerve disorders the itching could have rashes or not chronic
itching without a known cause is more of a problem as people age your nervous
system starts to wear out and and your nervous system has really kind of simply
put electrical signals that go back up to your brain and that wiring gets a
little bit rusty and off and your nerves start firing in ways that they probably
shouldn’t or don’t regulate the way that they should
that happens with aging we know that neurologic disorders are much more
common as you get older but the other thing we also recognize is that your
skin as a dermatologist that your skin gets weaker and drier more wrinkly and
thinner and so you’re now much more susceptible
to environmental insults to your skin and to the nerves that are go to your
skin and then the third thing is that we also know your immune system changes you
need vaccines when you’re a baby but you also now start to need to get vaccines
as you get older because your immune system starts to get imbalanced and it’s
really a combination of all those things that lead to some level of inflammation
your nerves going haywire your skin barrier not being able to recover from
insults that we think that really results in this kind of itch and why
it’s a problem he says he understands the frustration of chronic itch that
doctors can’t diagnose or effectively treat people will even on the extreme
end people will endorse suicidal thoughts
you know they can’t sleep if you can’t sleep the itch probably gets worse
everything gets worse your health starts to deteriorate you can’t concentrate you
can’t enjoy your you start developing anxiety it’s very rare that a patient
can get a drug like this approved to get an on label you’d have to do a big
clinical trial and prove that it’s really effective Karen feels fortunate
that she has her quality of life back to where it was before that first rash back
to being normal again I mean I can just be normal again I don’t have to worry
about it for HEC I’m Kathleen Berger

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