Moderne Therapien des Juckreizes

Zusammenfassung

Chronischer Pruritus (CP; Juckreiz) ist das häufigste Symptom bei dermatologischen Erkrankungen, kommt aber auch bei anderen Erkrankungen, wie z.B. der Inneren Medizin, der Neurologie, der Psychiatrie oder der Psychosomatik vor. In der täglichen klinischen Praxis kann Pruritus häufig gemischter Ätiologie sein, insbesondere mit zunehmendem Lebensalter der Betroffenen. In einem kleinen Anteil der Patienten bleibt, trotz intensiver Diagnostik, die Ursache unklar. Der erste Schritt der Behandlung besteht in der gründlichen Abklärung der zugrundeliegenden Ätiologie und der diesbezüglichen Therapie. Des Weiteren stehen lokale und systemische antipruritische Therapien zur Verfügung. Diese sind in der aktuellen deutschen Leitlinie und in der europäischen Leitlinie zur Therapie des CP umfassend dargelegt. In den vergangenen Jahren konnten neue Therapien zur Behandlung der chronischen Prurigo (CPG) überprüft werden und sind mittlerweile zugelassen. So steht Dupilumab seit 2022, Nemolizumab seit Anfang 2025 zur Therapie der Prurigo nodularis zur Verfügung. Die zur Therapie der Atopischen Dermatitis zugelassenen Biologika zeigen zum Teil gute antipruritische Wirkung, sind aber nicht für CP zugelassen. Mit den JAK-Inhibitoren stehen weitere neue topische und systemische Therapien zur Verfügung, die juckreizstillende Wirkung haben können. Es bleibt abzuwarten, ob diese zukünftig auch bei CP anderer Ursache wirksam sind.

Abstract

Chronic pruritus (CP; itching) is the most common symptom in dermatological diseases, but it also occurs in other specialities such as internal medicine, neurology, psychiatry, and psychosomatics. In everyday clinical practice, pruritus often has a mixed aetiology, especially as patients age. In a small proportion of patients, the cause remains unclear despite intensive diagnostic workup. The first step in treatment involves a thorough investigation of the underlying cause and the selection of appropriate therapy. In addition, both topical and systemic antipruritic treatments are available. These are comprehensively detailed in the current German and European guidelines for the treatment of CP. In recent years, new therapies for chronic prurigo have been evaluated and are now approved. Dupilumab has been available for the treatment of prurigo nodularis since 2022, and nemolizumab since early 2025. Biologics approved for atopic dermatitis have shown some sound antipruritic effects, but are not approved for CP. With JAK inhibitors, further new topical and systemic therapies with potential antipruritic effects have become available. It remains to be seen whether these will also prove effective in CP of other causes in the future.

Schlüsselwörter

Pruritus - Prurigo - Biologika

Keywords

pruritus - prurigo - biologics

Publication History

Article published online:
30 July 2025

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