Nazanin Foroutan1, Abbas Etminan2, Naemeh Nikvarz3, Mohadese Shojai Shahrokh Abadi4. 1. Faculty of Pharmacy and Pharmaceutical Sciences, Kerman University of Medical Sciences, Kerman, Iran. 2. Department of Nephrology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran. 3. Faculty of Pharmacy and Pharmaceutical Sciences, and Department of Nephrology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran. 4. Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Abstract
INTRODUCTION: Pruritus is one of the frustrating skin manifestations of advanced renal failure. Many options have been used for the management of uremic pruritus (UP) such as pregabalin. There are some studies that reported beneficial effects of pregabalin in reducing UP; however, most of them did not have a comparator arm. Therefore, we designed this study to compare antipruritic effects of pregabalin with doxepin in the management of pruritus in hemodialysis patients. METHODS:Seventy-two patients suffering from UP were randomly assigned to receive pregabalin (50 mg every other day) or doxepin (10 mg per day) for 4 weeks. Severity of pruritus and its effect on quality of life were assessed by visual analog scale (VAS), 5-D itch scale and dermatology life quality index (DLQI) at baseline and after 1 week, 2 weeks and 4 weeks of the treatment. FINDINGS:Mean scores of the VAS decreased from 7.5± 1.4 and 7.1 ± 1.3 at baseline to 2.1 ± 2.6 and 4.2 ± 2.6 at the end of the study (P < 0.001) in the pregabalin and doxepin groups, respectively. Similarly, pregabalin significantly reduced mean scores of the 5-D itch scale and the DLQI compared to doxepin. The most reported side effect in each group was somnolence which occurred in similar rates in the both groups. DISCUSSION: Pregabalin was more effective than doxepin in reducing the severity of uremic pruritus and improving the quality of life of patients in this study, so we suggest that clinician can consider pregabalin prior to using antihistamine drugs in the management of severe itch in hemodialysis patients.
RCT Entities:
INTRODUCTION:Pruritus is one of the frustrating skin manifestations of advanced renal failure. Many options have been used for the management of uremic pruritus (UP) such as pregabalin. There are some studies that reported beneficial effects of pregabalin in reducing UP; however, most of them did not have a comparator arm. Therefore, we designed this study to compare antipruritic effects of pregabalin with doxepin in the management of pruritus in hemodialysis patients. METHODS: Seventy-two patients suffering from UP were randomly assigned to receive pregabalin (50 mg every other day) or doxepin (10 mg per day) for 4 weeks. Severity of pruritus and its effect on quality of life were assessed by visual analog scale (VAS), 5-D itch scale and dermatology life quality index (DLQI) at baseline and after 1 week, 2 weeks and 4 weeks of the treatment. FINDINGS: Mean scores of the VAS decreased from 7.5± 1.4 and 7.1 ± 1.3 at baseline to 2.1 ± 2.6 and 4.2 ± 2.6 at the end of the study (P < 0.001) in the pregabalin and doxepin groups, respectively. Similarly, pregabalin significantly reduced mean scores of the 5-D itch scale and the DLQI compared to doxepin. The most reported side effect in each group was somnolence which occurred in similar rates in the both groups. DISCUSSION: Pregabalin was more effective than doxepin in reducing the severity of uremic pruritus and improving the quality of life of patients in this study, so we suggest that clinician can consider pregabalin prior to using antihistamine drugs in the management of severe itch in hemodialysis patients.
Authors: Gregory S Phillips; Jennifer Wu; Matthew D Hellmann; Michael A Postow; Naiyer A Rizvi; Azael Freites-Martinez; Donald Chan; Stephen Dusza; Robert J Motzer; Jonathan E Rosenberg; Margaret K Callahan; Paul B Chapman; Larisa Geskin; Adriana T Lopez; Vanessa A Reed; Gabriella Fabbrocini; Maria Carmela Annunziata; Oluwaseun Kukoyi; Aliyah Pabani; Chih-Hsun Yang; Wen-Hung Chung; Alina Markova; Mario E Lacouture Journal: J Clin Oncol Date: 2019-06-19 Impact factor: 50.717