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Pharmacological interventions for pruritus in adult palliative care patients

  1. Carola Xander1,*,
  2. Joerg J Meerpohl1,
  3. Daniel Galandi2,
  4. Sabine Buroh3,
  5. Guido Schwarzer1,
  6. Gerd Antes1,
  7. Gerhild Becker4

Editorial Group: Cochrane Pain, Palliative and Supportive Care Group

Published Online: 9 JUN 2013

Assessed as up-to-date: 1 APR 2013

DOI: 10.1002/14651858.CD008320.pub2


How to Cite

Xander C, Meerpohl JJ, Galandi D, Buroh S, Schwarzer G, Antes G, Becker G. Pharmacological interventions for pruritus in adult palliative care patients. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD008320. DOI: 10.1002/14651858.CD008320.pub2.

Author Information

  1. 1

    Institute of Medical Biometry and Medical Informatics, University Medical Center Freiburg, German Cochrane Centre, Freiburg, Germany

  2. 2

    University Medical Center Freiburg, Department of Oncology and Haematology and Stem Cell Transplantation, Freiburg, Germany

  3. 3

    University Medical Center, Library of the Surgical Clinic, Freiburg, Germany

  4. 4

    University Medical Center, Department of Palliative Care, Freiburg, Germany

*Carola Xander, German Cochrane Centre, Institute of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Robert-Koch-Straße 3, Freiburg, 79106, Germany. carola.xander@uniklinik-freiburg.de.

Publication History

  1. Publication Status: New
  2. Published Online: 9 JUN 2013

SEARCH

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Ashmore 2000 {published data only}
Bachs 1989 {published data only}
  • Bachs L, Parés A, Montserrat E, Piera C, Rodés J. Comparison of rifampicin with phenobarbitone for treatment of pruritus in biliary cirrhosis. Lancet 1989;18:574-6.
Bergasa 2006 {published data only}
Borgeat 1993 {published data only}
Breneman 1992b {published data only}
  • Breneman DL, Cardone JS, Blumsack RF, Lather RM, Searle EA, Pollack VE. Topical capsaicin for treatment of hemodialysis-related pruritus. Journal of the American Academy of Dermatology 1992;26(1):91-4.
Cho 1997 {published data only}
De Marchi 1992 {published data only}
  • De Marchi S, Cecchin E, Villalta D, Sepiacci G, Santini G, Bartoli E. Relief of pruritus and decreases in plasma histamine concentrations during erythropoietin therapy in patients with uremia. New England Journal of Medicine 1992;326(15):969-74.
Duncan 1984 {published data only}
  • Duncan JS, Kennedy HJ, Triger DR. Treatment of pruritus due to chronic obstructive liver disease. Brtish Medical Journal (Clin Res Ed) 1984;289(6436):22.
Duque 2005 {published data only}
  • Duque MI, Yosipovitch G, Fleischer AB Jr, Willard J, Freedman BI. Lack of efficacy of tacrolimus ointment 0.1% for treatment of hemodialysis-related pruritus: a randomized, double-blind, vehicle-controlled study. Journal of the American Academy of Dermatology 2005;52:519-21.
Ghent 1988 {published data only}
  • Ghent CN, Carruthers SG. Treatment of pruritus in primary biliary cirrhosis with rifampin. Results of a double-blind, crossover, randomized trial. Gastroenterology 1988;94(2):488-93.
Gunal 2004 {published data only}
  • Gunal AI, Ozalp G, Yoldas TK, Gunal SY, Kirciman E, Celiker H. Gabapentin therapy for pruritus in haemodialysis patients: a randomized, placebo-controlled, double-blind trial. Nephrology, Dialysis, Transplantation 2004;19(12):3137-9.
Kuiper 2010 {published data only}
Kumagai 2010 {published data only}
  • Kumagai H, Ebata T, Takamori K, Muramatsu T, Nakamoto H, Suzuki H. Effect of a novel kappa-receptor agonist, nalfurafine hydrochloride, on severe itch in 337 haemodialysis patients: a phase III, randomized, double-blind, placebo-controlled study. Nephrology, Dialysis, Transplantation 2010;25(4):1251-7.
Legroux-Crespel 2004 {published data only}
Makhlough 2010 {published data only}
  • Makhlough A. Topical capsaicin therapy for uremic pruritus in patients on hemodialysis. Iranian Journal of Kidney Diseases 2010;4(2):137-40.
Mayo 2007 {published data only}
Murphy 2003 {published data only}
Naini 2007 {published data only}
  • Naini AE, Harandi AA, Khanbabapour S, Shahidi S, Seirafiyan S, Mohseni M. Gabapentin: a promising drug for the treatment of uremic pruritus. Saudi Journal of Kidney Diseases and Transplantation 2007;18(3):378-81.
Nasrollahi 2007 {published data only}
  • Nasrollahi AR, Miladipour A, Ghanei E, Yavari P, Haghverdi F. Montelukast for treatment of refractory pruritus in patients on hemodialysis. Iranian Journal of Kidney Diseases 2007;1(2):73-7.
O'Donohue 2005 {published data only}
Özaykan 2001 {published data only}
  • Özaykan S, Mansur T, Gündüz S, Güney O. Comparison of ondansetron and cyproheptadine in treatment of uremic pruritus [Üremi Kaşintisi Olan Hastlarda Ondansetron ve Siproheptadinin Etkinliğinin Karşılaştırılması]. Türkderm 2001;35:130-4.
Pauli-Magnus 2000 {published data only}
  • Pauli-Magnus C, Mikus G, Alscher DM, Kirschner T, Nagel W, Gugeler N, et al. Naltrexone does not relieve uremic pruritus: results of a randomized, double blind, placebo-controlled crossover study. Journal of the American Society of Nephrology 2000;11:514-9.
Pederson 1980 {published data only}
  • Pederson JA, Matter BJ, Czerwinski AW, Llach F. Relief of idiopathic generalized pruritus in dialysis patients treated with activated oral charcoal. Annals of Internal Medicine 1980;93(3):446-8.
Peer 1996 {published data only}
Podesta 1991a {published data only}
Pour-Reza-Gholi 2007 {published data only}
  • Pour-Reza-Gholi F, Nasrollahi A, Firouzan A, Nasli Esfahani E, Farrokhi F. Low-dose doxepin for treatment of pruritus in patients on hemodialysis. Iranian Journal of Kidney Diseases 2007;1(1):34-7.
Silva 1994 {published data only}
  • Silva SR, Viana PC, Lugon NV, Hoette M, Ruzany F, Lugon JR. Thalidomide for the treatment of uremic pruritus: a crossover randomized double-blind trial. Nephron 1994;67(3):270-3.
Silverberg 1977 {published data only}
  • Silverberg DS, Iaina A, Reisin E, Rotzak R, Eliahou HE. Cholestyramine in uraemic pruritus. British Medical Journal 1977;1(6063):752-3.
Smith 1997 {published data only}
  • Smith KJ, Skelton HG, Yeager J, Lee RB, Wagner KF. Pruritus in HIV-1 disease: therapy with drugs which may modulate the pattern of immune dysregulation. Dermatology 1997;195(4):353-8.
Tarng 1996 {published data only}
  • Tarng DC, Cho YL, Liu HN, Huang TP. Hemodialysis-related pruritus: a double-blind, placebo-controlled, crossover study of capsaicin 0.025% cream. Nephron 1996;72(4):617-22.
Terg 2002 {published data only}
  • Terg R, Coronel E, Sordá J, Muñoz AE, Findor J. Efficacy and safety of oral naltrexone treatment for pruritus of cholestasis, a crossover, double blind, placebo-controlled study. Journal of Hepatology 2002;37:717-22.
Turner 1994a {published data only}
  • Turner IB, Rawlins MD, Wood P, James OF. Flumecinol for the treatment of pruritus associated with primary biliary cirrhosis. Alimentary Pharmacology & Therapeutics 1994;8(3):337-42.
Turner 1994b {published data only}
  • Turner IB, Rawlins MD, Wood P, James OF. Flumecinol for the treatment of pruritus associated with primary biliary cirrhosis. Alimentary Pharmacology & Therapeutics 1994;8(3):337-42.
Vessal 2010 {published data only}
  • Vessal G, Sagheb MM, Shilian S, Jafari P, Samani SM. Effect of oral cromolyn sodium on CKD-associated pruritus and serum tryptase level: a double-blind placebo-controlled study. Nephrology, Dialysis, Transplantation 2010;25(5):1541-7.
Villamil 2005 {published data only}
  • Villamil AG, Bandi JC, Galdame OA, Gerona S, Gadano AC. Efficacy of lidocaine in the treatment of pruritus in patients with chronic cholestatic liver diseases. The American Journal of Medicine 2005;118(10):1160-3.
Wikström 2005a {published data only}
  • Wikström B, Gellert R, Ladefoged SD, Danda Y, Akai M, Ide K, et al. Kappa-opioid system in uremic pruritus: multicenter, randomized, double-blind, placebo-controlled clinical studies. Journal of the American Society of Nephrology 2005;16:3742-7.
Wikström 2005b {published data only}
  • Wikström B, Gellert R, Ladefoged SD, Danda Y, Akai M, Ide K, et al. Kappa-opioid system in uremic pruritus: multicenter, randomized, double-blind, placebo-controlled clinical studies. Journal of the American Society of Nephrology 2005;16(12):3742-7.
Wolfhagen 1997 {published data only}
  • Wolfhagen FH, Sternieri E, Hop WC, Vitale G, Bertolotti M, Van Buuren HR. Oral naltrexone treatment for cholestatic pruritus: a double-blind, placebo-controlled study. Gastroenterology 1997;113(4):1264-9.
Young 2009 {published data only}
  • Young TA, Patel TS, Camacho F, Clark A, Freedman BI, Kaur M, et al. A pramoxine-based anti-itch lotion is more effective than a control lotion for the treatment of uremic pruritus in adult hemodialysis patients. Journal of Dermatological Treatment 2009;20(2):76-81.
Zylicz 2003 {published data only}
  • Zylicz Z, Krajnik M, Sorge AA, Costantini M. Paroxetine in the treatment of severe non-dermatological pruritus: a randomized, controlled trial. Journal of Pain and Symptom Management 2003;26(6):1105-12.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Almasio 2000 {published data only}
Aperis 2010 {published data only}
  • Aperis G, Paliouras C, Zervos A, Arvanitis A, Alivanis P. The use of pregabalin in the treatment of uraemic pruritus in haemodialysis patients. Journal of Renal Care 2010;36(4):180-5.
Aymard 1980 {published data only}
  • Aymard JP, Lederlin P, Witz F, Colomb JN, Herbeuval R, Weber B. Cimetidine for pruritus in Hodgkin's disease. British Medical Journal 1980;280(6208):151-2.
Balaskas 1998 {published data only}
Bergasa 1991 {published data only}
Bergasa 1992 {published data only}
  • Bergasa NV, Talbot TL, Alling DW, Schmitt JM, Walker EC, Baker BL, et al. A controlled trial of naloxone infusions for the pruritus of chronic cholestasis. Gastroenterology 1992;102:544-9.
Bergasa 1995 {published data only}
  • Bergasa NV, Alling DW, Talbot TL, Swain MG, Yurdaydin C, Turner ML, et al. Effects of naloxone infusions in patients with the pruritus of cholestasis. A double-blind, randomized, controlled trial. Annals of Internal Medicine 1995;123(3):161-7.
Bergasa 1999 {published data only}
  • Bergasa NV, Alling DW, Talbot TL, Wells MC, Jones EA. Oral nalmefene therapy reduces scratching activity due to the pruritus of cholestasis: a controlled study. Journal of the American Academy of Dermatology 1999;41(3 Pt 1):431-4.
Berman 1998 {published data only}
  • Berman B, Flores F, Burke G 3rd. Efficacy of pentoxifylline in the treatment of pruritic papular eruption of HIV-infected persons. Journal of the American Academy of Dermatology 1998;38(6):955-9.
Bigliardi 2007 {published data only}
  • Bigliardi PL, Stammer H, Jost G, Rufli T, Büchner S, Bigliardi-Qi M. Treatment of pruritus with topically applied opiate receptor antagonist. Journal of the American Academy of Dermatology 2007;56(6):979-88.
Borgeat 1994 {published data only}
  • Borgeat A, Mentha G, Savioz D, Wilder-Smith OH. Pruritus associated with liver disease: Propofol, a new therapeutic approach?. Schweizerische Medizinische Wochenschrift [Swiss Medical Weekly] 1994;124(15):649-50.
Bousquet 1989 {published data only}
  • Bousquet J, Rivory JP, Maheut M, Michel FB, Mion C. Double-blind, placebo-controlled study of nicergoline in the treatment of pruritus in patients receiving maintenance hemodialysis. Journal of Allergy and Clinical Immunology 1989;83(4):825-8.
Breneman 1992a {published data only}
  • Breneman DL, Cardone JS, Blumsack RF, Lather RM, Searle EA, Pollack VE. Topical capsaicin for treatment of hemodialysis-related pruritus. Journal of the American Academy of Dermatology 1992;26(1):91-4.
Castello 2011 {published data only}
  • Castello M, Milani M. Efficacy of topical hydrating and emollient lotion containing 10% urea ISDIN® plus dexpanthenol (Ureadin Rx 10) in the treatment of skin xerosis and pruritus in hemodialyzed patients: an open prospective pilot trial. Giornale Italiano Di Dermatologia e Venereologia [Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases] 2011;46(5):321-5.
Chen 2006 {published data only}
Datta 1966 {published data only}
Davis 2003 {published data only}
Easton 1978 {published data only}
  • Easton P, Galbraith PR. Cimetidine treatment of pruritus in polycythemia vera. New England Journal of Medicine 1978;299:1134.
Fjellner 1979 {published data only}
  • Fjellner B, Hagermark O. Pruritus in polycythemia vera: treatment with aspirin and possibility of platelet involvement. Acta Dermato-Venereologica 1979;59:505-12.
Ghorbani 2011 {published data only}
  • Ghorbani AR, Feily A, Khalili A, Dormanesh B. Lack of efficacy of topical calcineurin inhibitor pimecrolimus 1% on pruritus of severely uremic patients: a randomized double-blind study in 60 patients. Dermatitis 2011;22(3):167-8.
Giovanetti 1995 {published data only}
  • Giovannetti S, Barsotti G, Cupisti A, Dani L, Bandini S, Angelini D, et al. Oral activated charcoal in patients with uremic pruritus. Nephron 1995;70(2):193-6.
Goicoechea 1999 {published data only}
Goncalves 2010 {published data only}
  • Goncalves F. Thalidomide for the control of severe paraneoplastic pruritus associated with Hodgkin's disease. American Journal of Hospice & Palliative Medicine 2010;27(7):486-7.
Hellier 1963 {published data only}
  • Hellier FF. A comparative trial of trimeprazine and amylobarbitone in pruritus. Lancet 1963;1:471-2.
Jones 2005 {published data only}
Jones 2007 {published data only}
Juby 1994 {published data only}
Kato 2001 {published data only}
Korfitis 2008 {published data only}
  • Korfitis C, Trafalis DT. Carbamazepine can be effective in alleviating tormenting pruritus in patients with hematologic malignancy. Journal of Pain and Symptom Management 2008;35(6):571-2.
Kuypers 2004 {published data only}
  • Kuypers DR, Claes K, Evenepoel P, Maes B, Vanrenterghem Y. A prospective proof of concept study of the efficacy of tacrolimus ointment on uraemic pruritus (UP) in patients on chronic dialysis therapy. Nephrology, Dialysis, Transplantation 2004;19(7):1895-901.
Lysy 2003 {published data only}
  • Lysy J, Sistiery-Ittah M, Israelit Y, Shmueli A, Strauss-Liviatan N, Mindrul V, et al. Topical capsaicin-a novel and effective treatment for idiopathic intractable pruritus ani: a randomised, placebo controlled, crossover study. Gut 2003;52(9):1323-6.
Mansour-Ghanaei 2006 {published data only}
  • Mansour-Ghanaei F, Taheri A, Froutan H, Ghofrani H, Nasiri-Toosi M, Bagherzadeh AH, et al. Effect of oral naltrexone on pruritus in cholestatic patients. World Journal of Gastroenterology 2006;12(7):1125-8.
Marquez 2012 {published data only}
  • Marquez D, Ramonda C, Lauxmann JE, Romero CA, Vukelic VL, Martinatto C, et al. Uremic pruritus in hemodialysis patients: treatment with desloratidine versus gabapentin. Jornal Brasileiro Nefrologia 2012;34(2):148-52.
Metze 1999 {published data only}
  • Metze D, Reimann S, Beissert S, Luger T. Efficacy and safety of naltrexone, an oral opiate receptor antagonist, in the treatment of pruritus in internal and dermatological diseases. Journal of the American Academy of Dermatology 1999;41:533-9.
Montero 2006 {published data only}
  • Montero JL, Pozo JC, Barrera P, Fraga E, Costán G, Domínguez JL, et al. Treatment of refractory cholestatic pruritus with molecular adsorbent recirculating system (MARS). Transplantation Proceedings 2006;38(8):2511-3.
Müller 1998a {published data only}
  • Müller C, Pongratz S, Pidlich J, Penner E, Kaider A, Schemper M, et al. Treatment of pruritus in chronic liver disease with the 5-hydroxytryptamine receptor type 3 antagonist ondansetron: a randomized, placebo-controlled, double-blind cross-over trial. European Journal of Gastroenterology & Hepatology 1998;10(10):865-70.
Müller 1998b {published data only}
  • Müller C, Pongratz S, Pidlich J, Penner E, Kaider A, Schemper M, et al. Treatment of pruritus in chronic liver disease with the 5-hydroxytryptamine receptor type 3 antagonist ondansetron: a randomized, placebo-controlled, double-blind cross-over trial. European Journal of Gastroenterology & Hepatology 1998;10:865-70.
Podesta 1991b {published data only}
Price 1998 {published data only}
Prieto 2004 {published data only}
Razeghi 2009 {published data only}
Rifai 2006 {published data only}
  • Rifai K, Hafer C, Rosenau J, Athmann C, Haller H, Peter Manns M, et al. Treatment of severe refractory pruritus with fractionated plasma separation and adsorption (Prometheus ®). Scandinavian Journal of Gastroenterology 2006;41(10):1212-7.
Sja'bani 1997 {published data only}
  • Sja'bani M, Asdie AH. Effect of erythropoietin on pruritus and quality of life in chronic hemodialyzed end stage renal disease patients. Journal of Clinical Epidemiology 1997;50 Suppl 1:10S.
Ständer 2009 {published data only}
  • Ständer S, Böckenholt B, Schürmeyer-Horst F, Weishaupt C, Heuft G, Luger TA, et al. 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. Acta Dermato-Venereologica 2009;89:45-51.
Szepietowski 2005 {published data only}
  • Szepietowski JC, Szepietowski T, Reich A. Efficacy and tolerance of the cream containing structured physiological lipids with endocannabinoids in the treatment of uremic pruritus: a preliminary study. Acta Dermatovenerologica Croatica 2005;13(2):97-103.
Tokgöz 2005 {published data only}
  • Tokgöz B, Ata A, Sİpahİoğlu M, Oymak O, Utaş S, Utaş C. Effects of oral granisetron treatment on uremic pruritus. Turkish Journal of Medical Sciences 2005;35:93-7.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Feily 2012 {published data only}
  • Feily A, Dormanesh B, Ghorbani AR, Moosavi Z, Kouchak M, Cheraghian B, et al. Efficacy of topical cromolyn sodium 4% on pruritus in uremic nephrogenic patients: a randomized double-blind study in 60 patients. International Journal of Clinical Pharmacology and Therapeutics 2012;50(7):510-3.
Najafabadi 2012 {published data only}

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
NCT00577967 {unpublished data only}
  • Siu YP, Tong KH, Leung KT, Kwan TH, Au, TC. Gabapentin - A Solution to Uremic Pruritus? A Prospective, Randomized, Placebo-controlled, Double-blind Study. http://clinicaltrials.gov. Accessed: 28 August 2012, issue NCT00577967.
NCT00693654 {unpublished data only}
  • Fleischer A. A Controlled Comparative Study of the Efficacy of SARNA Sensitive Lotion for Treatment of Uremic Pruritus in Adult Hemodialysis Patients. http://clinicaltrials.gov. Accessed: 28 August 2012.
NCT00756171 {unpublished data only}
  • NN. Colesevelam Versus Placebo in Cholestatic Pruritus. A Double-blind, Placebo-controlled Study. http://clinicaltrials.gov. Accessed: 28 August 2012.
NCT00793156 {unpublished data only}
  • NN, Acologix, Inc. A Randomized-Withdrawal Phase 3 Study Evaluation the Safety and Efficacy of Oral Nalfurafine HCl (AC-820)in Subjects on Hemodialysis With Uremic Pruritus (Renal Itch). http://clinicaltrials.gov. Accessed: 28 August 2012.
NCT01114672 {unpublished data only}
  • Schanler M, Fishbane S. A Randomized Prospective, Double-Blind Placebo Controlled Study of Oral Ergocalciferol in the Treatment of Pruritus in Hemodialysis Patients. http://clinicaltrials.gov. Accessed: 28 August 2012 A.
NCT01513161 {unpublished data only}
  • Kim SG. 14 Day, Multi-center, Randomized, Double Blinded, Placebo-controlled, Parallel Group, Fixed Dose, Phase III Clinical Trial to Assess the Efficacy and Safety of TRK-820 in Treating Conventional-treatment-resistant Pruritus in Patients Receiving Hemodialysis. http://clinicaltrials.gov. Accessed: 28 August 2012.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
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  • Ahern K, Gilmore ES, Poligone B. Pruritus in cutaneous T-cell lymphoma: A review. Journal of the American Academy of Dermatology: JAAD 2012;Jan 26:[E-pub ahead of print].
Bergasa 2008
Bernhard 2005
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Mettang 2002
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Mettang 2010
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Metz 2010
Metze 1999a
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Misery 2010
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Moore 2009
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