Impact of drug therapy on brachioradial pruritus

Abstract

Few studies have described therapeutic options in brachioradial pruritus. We describe a cross-sectional study of brachioradial pruritus patients treated in an outpatient unit. We reviewed medical records and interviewed brachioradial pruritus patients without indication for decompressive surgery, in order to access the perceptions of intensity of pruritus prior to treatment and response to therapy. We found that antidepressants and anticonvulsants were the most frequently prescribed drugs. Best reductions in pruritus were associated with its highest intensities prior to treatment, and with longer periods of therapy.

Treatment of Brachioradial Pruritus: A Systematic Review

“…The most commonly cited oral medication for BRP treatment is gabapentin with eight articles (three retrospective studies, one case series, four case reports; n=26) reporting on gabapentin efficacy. 4,5,10,19,[21][22][23][24] Effective doses range from 300 mg once daily to six times daily. 19,[21][22][23] However, side effects such as sedation and gastrointestinal upset may limit the upper limit of dosing in some patients.…”

“…22 Retrospective studies note complete resolution of BRP in 20% to 42% of patients, while partial symptomatic control was achieved in 20% to 28.5%. 5,10 Other anticonvulsants used for BRP include pregabalin, lamotrigine, and carbamazepine. 5,25,26 One prospective study and one case report (n=4) noted improvement in pruritus with pregabalin.…”

“…5 Antidepressants, such as amitriptyline, doxepin and fluoxetine, and antipsychotics, such as risperidone, pimozide and chlorpromazine, have occasionally been used to treat BRP. 4,5,10 Two retrospective studies (n=53) noted these medications have a similar effect as gabapentin, with a majority of patients noting either "excellent" or "good" reduction in pruritus. Unfortunately, no doses were reported.…”

“…Unfortunately, no doses were reported. 4,10 Antihistamines and NSAIDs are rarely prescribed for BRP. While antihistamines are classically thought to be anti-pruritic, they are typically ineffective in BRP.…”

“…After removing duplicate data (Pinto et al/Waccholz et al and Pereira et al/Stienke et al), 399 patients with BRP were included. 4,[9][10][11] Given that most data on BRP treatment comes from case series and reports, the overall quality of the evidence reviewed is low (Table 1-4).…”