Antipruritic effects of two different 5‐HT3 receptor antagonists and an antihistamine in haemodialysis patients

Weißhaar, Elke; Dunker, Nadine; Röhl, Friedrich-Wilhelm; Gollnick, Harald

doi:10.1111/j.0906-6705.2004.00184.x

Cited by 68 publications

(45 citation statements)

References 22 publications

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“…2,[77][78][79] Because of the potential for dangerous side effects related to over-sedation, especially in the elderly, these medications cannot be recommended as first line for the treatment of CKD-aP.…”

Section: Antihistamine Treatmentmentioning

confidence: 99%

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

103

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Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments. Several large well-designed treatment trials have recently been completed and may soon influence CKD-aP management.

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Section: Antihistamine Treatmentmentioning

confidence: 99%

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

103

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“…However, current research reveals mixed reports in this area, and the effectiveness of treatment may vary according to the type of pruritus studied. For example, in patients with cholestatic itch, either some or no benefit has been reported [120,121], whilst only marginal or no relief has been reported for hemodialysis-related pruritus [122,123]. However, the underlying mechanisms of this disorder are still poorly understood and will need further work if a therapeutic potential is to be realised [124].…”

Section: Therapeutic Potentialmentioning

confidence: 99%

5-HT3 Receptors

Thompson

Lummis

2006

CPD

205

173

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The 5-HT(3) receptor is a member of the Cys-loop family of ligand-gated ion channels. These receptors are located in both the peripheral and central nervous systems, where functional receptors are constructed from five subunits. These subunits may be the same (homopentameric 5-HT(3A) receptors) or different (heteropentameric receptors, usually comprising of 5-HT(3A) and 5-HT(3B) receptor subunits), with the latter having a number of distinct properties. The 5-HT(3) receptor binding site is comprised of six loops from two adjacent subunits, and critical ligand binding amino acids in these loops have been largely identified. There are a range of selective agonists and antagonists for these receptors and the pharmacophore is reasonably well understood. There are also a wide range of compounds that can modulate receptor activity. Studies have suggested many diverse potential disease targets that might be amenable to alleviation by 5-HT(3) receptor selective compounds but to date only two applications have been fully realised in the clinic: the treatment of emesis and irritable-bowel syndrome.

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“…During the past years., clinical research has focussed on the antipruritic efficacy of centrally acting substances, such as opioid receptor agonists and antagonists as well as on serotonin subtype 3 receptor (5-HT3 ) antagonists (3)(4)(5)(6)(7). While mu-opioid antagonists and kappa-opioid agonists demonstrated clinical benefit in certain fomis of chronic pruritus, 5-HT3-antagonists did not prove significant antipruritic effects (8). Among the conventionally applied centrally acting antipruritic drugs, tricyclic and tetracyclic antidepressants, such as doxepine, amitriptyline or mirtazapine.…”

mentioning

confidence: 99%

Treatment of Chronic Pruritus with the Selective Serotonin Re-uptake Inhibitors Paroxetine and Fluvoxamine: Results of an Open-labelled, Two-arm Proof-of-concept Study

Böckenholt²,

et al. 2009

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Chronic pruritus is difficult to treat and requires the evaluation of new therapeutic modalities. We initiated an open-labelled, two-arm prospective, proof-of-concept study applying two selective serotonin re-uptake inhibitors on a long-term basis. Paroxetine and fluvoxamine were tested in a total of 72 pruritic patients (27 men, 45 women, age range 28-88 years, mean age 59.2 years). The reduction in pruritus was evaluated by analysis of visual analogue scores and determination of the maximal antipruritic effect (maximal percentual reduction in pruritus). Forty-nine of 72 patients (68.0%) experienced a weak (n=9), good (n=16) or very good (n=24) antipruritic effect. Statistical analysis proved the efficacy of paroxetine and fluvoxamine with no significant difference. The best response was observed in patients with pruritus due to atopic dermatitis, systemic lymphoma and solid carcinoma. Chronic scratch lesions healed completely in 14/31 patients and partially in 17/31 patients. Adverse drug effects were observed in 70.8% of patients, resulting in discontinuation of treatment in 18 patients. These results support previous reports of high antipruritic potency of selective serotonin re-uptake inhibitors, which are a good alternative treatment modality in chronic pruritus. This should be confirmed in future double-blind studies.

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Antipruritic effects of two different 5‐HT3 receptor antagonists and an antihistamine in haemodialysis patients

Cited by 68 publications

References 22 publications

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

5-HT3 Receptors

Treatment of Chronic Pruritus with the Selective Serotonin Re-uptake Inhibitors Paroxetine and Fluvoxamine: Results of an Open-labelled, Two-arm Proof-of-concept Study

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