{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:55:10Z","timestamp":1791849310477,"version":"4.3.4"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Injection pain and needle\u2010related anxiety may limit acceptance and continuation of biologic therapy in children with atopic dermatitis (AD). Real\u2010world data on injection pain during nemolizumab treatment is limited. We aimed to longitudinally quantify injection pain during nemolizumab treatment under standardized vibration\u2010and\u2010cooling analgesia and evaluate early clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational cohort study enrolled children aged 6\u201312\u2009years with moderate\u2010to\u2010severe AD\u00a0who\u00a0had completed 16\u2009weeks of nemolizumab treatment (30\u2009mg every 4\u2009weeks) between June 2024 and July 2025. All injections were administered with standardized vibration\u2010and\u2010cooling analgesia. Injection pain was assessed immediately after each injection using the Wong\u2013Baker FACES Pain Rating Scale (0\u201310). Secondary outcomes included the Peak Itch Numeric Rating Scale (NRS), Patient\u2010Oriented Eczema Measure (POEM), and Eczema Area and Severity Index (EASI) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 13 children provided 62 of 65 planned pain ratings. Injection pain was consistently minimal (median 0; interquartile range [IQR] 0\u20132); no child reported severe pain (score \u2265\u20098). At Week 16, the median EASI reduction was 87.5% (IQR, 73.7\u201390.3); EASI\u201075 was achieved by 9 of 13 (69.2%) participants. Median peak itch NRS improved by 5.0 points (IQR, 3.0\u20136.0), and median POEM improved by 7.0 points (IQR, 4.0\u201312.0). No serious adverse events occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Under standardized vibration\u2010and\u2010cooling analgesia, nemolizumab administration was associated with minimal injection pain and substantial early clinical improvement; these findings do not represent the intrinsic injection pain of nemolizumab without analgesia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pde.70387","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:30:56Z","timestamp":1791847856000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Injection\u2010Related Pain During Nemolizumab Treatment With Standardized Vibration\u2010and\u2010Cooling Analgesia in Children With Atopic Dermatitis: A Real\u2010World Observational Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4163-1668","authenticated-orcid":false,"given":"Tomoaki","family":"Kunitsu","sequence":"first","affiliation":[{"name":"Department of Pediatrics Saiseikai Moriyama Municipal Hospital  Moriyama Shiga Japan"},{"name":"Department of Pediatrics Allergy and Immunology Shiga General Hospital  Moriyama Shiga Japan"},{"name":"Department of Pediatrics Shiga University of Medical Science  Otsu Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Hamanaka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Saiseikai Moriyama Municipal Hospital  Moriyama Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Tagaya","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Saiseikai Moriyama Municipal Hospital  Moriyama Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Nonomura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Saiseikai Moriyama Municipal Hospital  Moriyama Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)31286\u20101"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2016.07.012"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.03.018"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljad268"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2022.04.003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010019\u201001101\u20106"},{"key":"e_1_2_11_8_1","unstructured":"Wong\u2013Baker FACES Foundation \u201cWong\u2013Baker FACES Pain Rating Scale \u201daccessed December 15 2025 https:\/\/wongbakerfaces.org\/."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553\u20102712.2009.00620.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2020.02.006"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000037522"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e318237ace4"},{"key":"e_1_2_11_13_1","unstructured":"Maruho Co. Ltd. \u201cMitchga (Nemolizumab) for Subcutaneous Injection [Japanese Prescribing Information] \u201daccessed December 28 2025 https:\/\/www.maruho.co.jp\/medical\/pdf\/products\/mitchga\/mitchga_vi_te.pdf."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.70218"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.70387","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.70387","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.70387","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:30:59Z","timestamp":1791847859000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.70387"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":13,"alternative-id":["10.1111\/pde.70387"],"URL":"https:\/\/doi.org\/10.1111\/pde.70387","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2026-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pde.70387"}}