Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: A prospective, crossover study

Solak, Yalçın; Bıyık, Zeynep; Atalay, Hüseyin; Gaipov, Abduzhappar; Güney, Figen; Türk, Süleyman; Covic, Adrian; Goldsmith, David; Kanbay, Mehmet

doi:10.1111/j.1440-1797.2012.01655.x

Cited by 86 publications

(97 citation statements)

References 23 publications

(41 reference statements)

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“…108 Several studies of SRA have been undertaken with generally negative results. 75,99,109,110 In a non-controlled, unblinded trial of 14 HD patients, granisetron, an anti-emetic and SRA, significantly improved pruritus severity over 4 weeks of therapy. 111 However, in a double-blind, crossover RCT of 24 patients on HD, 8 mg of ondansetron 3 times daily over 2 weeks did not significantly improve CKD-aP compared to placebo.…”

Section: Other Medicationsmentioning

confidence: 99%

“…98 A recent qualitative systematic review of 7 studies evaluating gabapentin (179 participants) supported a trial of gabapentin for the treatment of CKD-aP refractory to antihistamines and/or emollients. 97 Pregabalin, a medication similar to gabapentin, may also improve CKD-aP 37,99 and may be particularly useful when patients are not able to tolerate gabapentin. 1,100 In a randomized, crossover trial, 50 HD patients were assigned to gabapentin 300 mg or pregabalin 75 mg daily.…”

mentioning

confidence: 99%

“…98 In a double-blind trial of 188 HD or PD patients, randomized to 75 mg of pregabalin twice weekly or 8 mg/day of ondansetron or placebo, only pregabalin significantly improved pruritus severity over the 12-week treatment period. 99 In a study of 71 patients (stage 4 and 5 CKD and dialysis) treated with gabapentin or pregabalin, both the medications significantly improved pruritus intensity. In addition, pregabalin relieved itching in 13 of 16 patients who were unable to tolerate gabapentin after a median treatment period of 2.5 months.…”

mentioning

confidence: 99%

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

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

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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: Other Medicationsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

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

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

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show abstract

“…Gabapentin has been found to be effective in uremic pruritus, [13][14][15] burns, 16 notalgia paresthestica, 17 neuropathic itch, 14 and itch occurring in palliative patients. 13,18 Additional agents that should be considered for the treatment of itch include pregabalin, mirtazapine, butorphenone, naltrexone, aprepitant, and narrow-band ultraviolet B.…”

Section: Limited Treatment Options For Pruritusmentioning

confidence: 99%

“…13,18 Additional agents that should be considered for the treatment of itch include pregabalin, mirtazapine, butorphenone, naltrexone, aprepitant, and narrow-band ultraviolet B. 9,13,14,[19][20][21][22] Of note, placebo effects on itch are common, 23 which may explain why some patients report improvement of their itch even with several non-evidence-based treatments. Nevertheless, health care professionals should use evidence-based treatments wherever possible.…”

Section: Limited Treatment Options For Pruritusmentioning

confidence: 99%

Practice Gaps in Pruritus

Silverberg

2016

Dermatologic Clinics

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Pruritus in the Older Patient

Berger

Shive

Harper

2013

JAMA

115

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The Patient's StoryMr A is 85 years old and has multiple skin abnormalities with intractable pruritus of the trunk, groin, perianal area, face, and scalp. He cannot sleep for more than 4 to 5 hours per night because of his pruritus. Mr A was diagnosed as having seborrheic dermatitis, lichen simplex chronicus, seborrheic keratoses, tinea pedis, intertrigo, and xerosis (dry skin) in 2000. Treatments included numerous topical steroids and antifungals. None were effective, leaving Mr A significantly stressed.Mr A lives with his wife in an assisted-living facility. He requires help with dressing, transferring, using the telephone, shopping, and managing medications. His medical history includes type 2 diabetes mellitus, obesity, chronic kidney disease, and significant cardiovascular, cerebrovascular, and peripheral vascular disease. He has had 2 coronary artery bypass graft operations, 2 left carotid endarterectomies, and a left femoral-popliteal bypass operation. He also underwent multilevel lumbar laminectomy for spinal stenosis.His list of 28 oral and inhaled medications includes rosuvastatin and amlodipine. At one visit to Dr I, his geriatrician, Mr A produced 14 different tubes of topical medications, including multiple steroids and antifungals. He and his wife did not understand when and where to apply these medications. Mr A's skin was dry, with erythematous patches, seborrheic keratoses, and areas of excoriation on his trunk. He had bilateral inguinal fold and perianal erythema with a few white perianal plaques and several fissures. On monofilament testing, cutaneous sensation in his feet was absent. Screening for depression was unrevealing. His laboratory test results were notable for mild anemia, elevated creatinine, and normal liver function and routine chemistries.Mr A had several UV-B light treatments, which were minimally helpful. Mr A used over-the-counter diphenhydramine to help him sleep even though Dr I had advised against it because of potential anticholinergic adverse effects. Ultimately, Dr I, in collaboration with IMPORTANCE Pruritus is a common problem among elderly people and, when severe, causes as much discomfort as chronic pain. Little evidence supports pruritus treatment, limiting therapeutic possibilities and resulting in challenging management problems.OBJECTIVES To present the evidence on the etiology, diagnosis, and treatment of pruritus in the elderly and, using the best available evidence, provide an approach for generalist physicians caring for older patients with pruritus.EVIDENCE REVIEW PubMed and EMBASE databases were searched (1946( -August 2013.The Cochrane Database of Systematic Reviews and the Agency for Healthcare Research and Quality Systematic Review Data Repository were also searched from their inception to August 2013. References from retrieved articles were evaluated.FINDINGS More than 50% of elderly patients have xerosis (dry skin). Xerosis treatment should be included in the initial therapy for pruritus in all elderly patients. Calcium channel blockers and hydrochlorot...

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Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: A prospective, crossover study

Abstract: Treatment of neuropathic pain with either pregabalin or gabapentin effectively ameliorates uraemic itch.

Cited by 86 publications

References 23 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

Practice Gaps in Pruritus

Pruritus in the Older Patient

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