Challenges and Treatment Options for Itching in Epidermolysis Bullosa: Results from 21 Studies

Itch is a challenging and distressing symptom of Epidermolysis Bullosa (EB) that greatly diminishes patients' quality of life. While several treatments are available, most offer only limited relief. Researchers from the EB House Austria, in collaboration with others, analyzed 21 studies involving 353 patients to evaluate current therapies for itch in EB, publishing their results in a comprehensive review article. Their findings revealed that only a few treatments significantly reduced itch, with most showing little to no effect.

Differences in study design and the ways outcomes were measured made it challenging to compare the effectiveness of the various treatments. In most studies, itch was not the primary focus, and 18 different tools to measure itch, quality of life, and disease severity were used. This lack of consistency, along with incomplete data on whether these tools were suitable for patients of different ages, further complicated the analysis.

The researchers conducted an in-depth analysis of 17 treatments, including systemic therapies that impact the entire body, as well as local treatments applied to specific areas of the skin. The results for cell therapies, such as mesenchymal stem cell infusions, were mixed, with some studies showing improvement in itch. Protein therapies, such as collagen-based skin substitutes, alleviated itching around wounds. Small molecule treatments, particularly omalizumab, were among the few that significantly reduced itch, whereas most other therapies showed limited or no effectiveness.

Patient surveys suggest that cannabinoid-based medicines can effectively ease itching. Importantly, most studies have not shown a significant increase in side effects associated with these treatments. While some methods demonstrate promise, the inconsistent reporting and potential biases in many studies highlight the necessity for more rigorous, large-scale trials to identify improved strategies for managing itch in patients with EB.

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