Gabapentin versus dexchlorpheniramine as treatment for uremic pruritus: a randomised controlled trial

Gobo-Oliveira, Mariele; Pigari, Vitória G; Ogata, Matheus S. P.; Miot, Hélio Amante; Ponce, Daniela; Abbade, Luciana Patrícia Fernandes

doi:10.1684/ejd.2018.3356

Cited by 23 publications

(29 citation statements)

References 17 publications

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“…Out of 71 patients, nine (12%) had complete resolution of pruritus and were not included in phase 2. After phase 2, median pruritus VAS scores were significantly reduced by 80% in both groups [5 (4–8) to 2 (0–3) in GABA group and 5 (3–7) to 1 (0–2) in DEX group] ( P < 0.01) with no differences between them ( P > 0.07) (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Two of these studies had crossover design comparing gabapentin to placebo and pregabalin . Five were parallel‐arm studies comparing gabapentin to placebo, and antihistamines such as hydroxyzine, ketotifen, and dexchlorpheniramine (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Subjects had no anemia, hyperparathyroidism, hypophosphatemia, and or other skin or systemic diseases that might be the cause of pruritus. Ten centimeter or 100 mm pruritus visual analogue scale (VAS) was used in six studies, wherein subjects were trained to evaluate pruritus severity with 10 or 100 horizontal lines marked from 0 to 10 or 0 to 100 (0 stands for no pruritus and 10 or 100 stands for worst possible itch) . One study used Shiratori's pruritus severity scoring system, wherein 0 stands for no itching, 1 for minimal, 2 for mild, 3 for moderate, and 4 for severe itching …”

Section: Resultsmentioning

confidence: 99%

“…In the study of Gobo‐Oliveira et al, all patients were instructed to apply cold cream for 15 days (prerandomization phase or phase 1) prior to the treatment (randomization phase or phase 2). Those who still complained of pruritus after phase 1 were randomized into two groups . For 21 days, during phase 2, the GABA group was given gabapentin 300 mg thrice weekly while the DEX group was given 6 mg dexchlorpheniramine twice daily.…”

Section: Resultsmentioning

confidence: 99%

“…In the DEX group, eight (26.6%) had side effects. Other reported adverse drug events included sleepiness, fatigue, dizziness, and headache . The risk of experiencing these side effects was higher with gabapentin treatment, but the results were not significant (RR = 1.37, P = 0.4098) (Table ).…”

Section: Resultsmentioning

confidence: 99%

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Gabapentin for uremic pruritus: a systematic review of randomized controlled trials

2019

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Uremic pruritus is one of the most prevalent and bothersome dermatologic symptoms in patients with end‐stage renal disease. Some studies suggest a possible neuropathic cause of uremic pruritus. Gabapentin, an anticonvulsant, may control pruritus with neuropathic origin. The objectives of this study were to assess the efficacy of gabapentin in reducing pruritus scores of patients with uremic pruritus and evaluate its safety among dialysis patients. Meta‐analysis of randomized controlled trials, using gabapentin as treatment for uremic pruritus among hemodialysis patients was included and analyzed using Review Manager Version 5.1.4 software. Seven out of 17 screened articles were included, with a total of 315 participants. Meta‐analysis of the incidence of improved pruritus scores after treatment from four studies (n = 171) showed that treatment with gabapentin decreased the severity of uremic pruritus as compared to the placebo (risk ratio = 0.18; 95% confidence interval: 0.09, 0.33; I2 = 4%: P =< 0.00001). Six studies (n = 290) presented with incidence of adverse drug events such as dizziness, drowsiness, and somnolence. In the pooled analysis, treatment with gabapentin was associated with a higher incidence of adverse drug events compared to the comparator drugs, but the results were not significant (risk ratio = 1.3, 95% confidence interval: 0.81, 2.11; P = 0.28, I2 = 37%). The results of this systematic review suggest that gabapentin is efficacious and safe in improving uremic pruritus among dialysis patients.

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Section: Resultsmentioning

confidence: 99%