How does nemolizumab fit into your current treatment approach to prurigo nodularis relative to other biologics?

It is my first-line recommendation.

Unless the patient has a history of significant asthma (to me, this would mean daily use of an inhaler or history of hospitalization for asthma), I have a slight preference for nemolizumab over dupilumab. These are the only two biologics approved for PN right now, though I suspect the other anti-IL-...