Uremic pruritus in hemodialysis patients: treatment with desloratidine versus gabapentin

Jornal Brasileiro de Nefrologia

Diego Marquez²  Carolina Ramonda²  Jorge E. Lauxmann²  Cesar A. Romero¹  Valeria L. Vukelic²  Carolina Martinatto²  Belén Barrón²  Pablo A. Novoa²  Aldo J. Peixoto²  Marcelo Orías² 

[1] ,Sanatorio AllendeCordoba,Argentina

关键词: Pruritus;    Histamine antagonists;    Renal dialysis;    Prurido;    Antagonistas histamínicos;    Diálise renal;   

DOI  :  10.1590/S0101-28002012000200007

来源: SciELO

【 摘 要 】

INTRODUCTION: Uremic pruritus is common among dialysis patients. Effective treatments are not readily available. Early evidence with antihistamines and gabapentin indicate variable effects. OBJECTIVE: To compare the efficacy and side effects of gabapentin and desloratadine in patients with dialysis pruritus. METHODS: Prospective, open-label, cross-over clinical trial in 22 patients on chronic hemodialysis with sustained pruritus over a period of at least 60 days. After a one-week run-in period, we assigned patients to three weeks of either gabapentin 300 mg thrice weekly or desloratadine 5 mg thrice weekly. After a one-week washout period, each patient crossed-over to the alternate regimen for three more weeks. The primary endpoint of the study was the change in the visual analogue pruritus score (VAS). RESULTS: Nineteen subjects completed the two treatment blocks and were available for analysis. VAS scores decreased with both treatments (5.95 to 4.6 with gabapentin, p = 0.07; 5.89 to 3.4 with desloratadine, p = 0.004), but only desloratadine reached statistical significance. There were no differences when comparing the final pruritus score with gabapentin and desloratadine (4.6 versus 3.4, p = 0.16) Excessive sedation was common with gabapentin. Desloratadine was well tolerated. CONCLUSION: Desloratadine provides significant relief of uremic pruritus compared with no therapy. gabapentin has marginal efficacy. Desloratadine is better tolerated than gabapentin.

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