BACKGROUND: Treatment of uremic pruritus (UP) is a big challenge. OBJECTIVES: To evaluate efficacy, appropriate dosing regimen and safety of gabapentin on UP in hemodialysis (HD) patients. PATIENTS AND METHODS: Fifty-four uremic patients undergoing HD and complaining of UP were randomly classified into two equal groups. Gabapentingroup: 27 patients receivedgabapentin capsules starting with 100 mg and gradually titrated up to a maximum of 300 mg after each HD session for one month. Placebogroup: 27 patients receivedplacebo thrice weekly after each HD session. Severity of pruritus was measured by visual analog scale (VAS) and 5-D pruritus scale. RESULTS: In gabapentingroup, 88.9% of patients responded well to gabapentin versus 22.2% in placebogroup. A highly statistical difference was detected in favor of gabapentingroup (p< 0.001). The frequency of the use of the lowest dose (100 mg thrice weekly) was significantly higher than other doses (p < 0.0001). Adverse effects were mild and tolerated. CONCLUSION:Gabapentin is a promising and a well-tolerated treatment option for patients with UP. We recommend it as a first line therapy with a maintenance post-HD dose of 100-300 mg. We also recommend the 5-D scale in the assessment of the severity of pruritus.
RCT Entities:
BACKGROUND: Treatment of uremic pruritus (UP) is a big challenge. OBJECTIVES: To evaluate efficacy, appropriate dosing regimen and safety of gabapentin on UP in hemodialysis (HD) patients. PATIENTS AND METHODS: Fifty-four uremic patients undergoing HD and complaining of UP were randomly classified into two equal groups. Gabapentin group: 27 patients received gabapentin capsules starting with 100 mg and gradually titrated up to a maximum of 300 mg after each HD session for one month. Placebo group: 27 patients received placebo thrice weekly after each HD session. Severity of pruritus was measured by visual analog scale (VAS) and 5-D pruritus scale. RESULTS: In gabapentin group, 88.9% of patients responded well to gabapentin versus 22.2% in placebo group. A highly statistical difference was detected in favor of gabapentin group (p< 0.001). The frequency of the use of the lowest dose (100 mg thrice weekly) was significantly higher than other doses (p < 0.0001). Adverse effects were mild and tolerated. CONCLUSION:Gabapentin is a promising and a well-tolerated treatment option for patients with UP. We recommend it as a first line therapy with a maintenance post-HD dose of 100-300 mg. We also recommend the 5-D scale in the assessment of the severity of pruritus.
Authors: Julie H Ishida; Charles E McCulloch; Michael A Steinman; Barbara A Grimes; Kirsten L Johansen Journal: J Am Soc Nephrol Date: 2018-06-05 Impact factor: 10.121
Authors: Hugh C Rayner; Maria Larkina; Mia Wang; Matthew Graham-Brown; Sabine N van der Veer; Tevfik Ecder; Takeshi Hasegawa; Werner Kleophas; Brian A Bieber; Francesca Tentori; Bruce M Robinson; Ronald L Pisoni Journal: Clin J Am Soc Nephrol Date: 2017-09-18 Impact factor: 8.237