The correct answer is A. Interleukin (IL) 31 inhibitor.

The correct answer is A) Interleukin (IL) 31 inhibitor. Nemolizumab, sold under the brand name Nemluvio, is a FDA approved systemic biologic for the treatment of moderate to severe (severe itch and more than 20 lesions) prurigo nodularis in patients 18 years and older. It works by inhibiting IL-31, which blocks itch signals.

Choice B is incorrect, as nemluvio inhibits, not activates, IL-31. Answer choice C is incorrect, as it is the mechanism of action of apremilast, and D is adalimumab, and E is secukinumab, which are used to treat psoriasis, amongst other skin diseases. Of note, in patient’s with severe itch and severe prurigo nodularis, it is important to rule out systemic underlying diseases in their workup (such as renal or hepatic disease, lymphoma/myeloproliferative disorders, endocrine/metabolic disorders, etc).

References: Yokozeki H, Murota H, Matsumura T. Long-term (68 weeks) administration of nemolizumab and topical corticosteroids for prurigo nodularis in patients aged ≥ 13 years: efficacy and safety data from a phase II/III study. Br J Dermatol. 2025;193(1):56-65. doi:10.1093/bjd/ljaf045

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