Uremic Pruritus in Hemodialysis Patients: Treatment With Desloratidine Versus Gabapentin

Diego Marquez, Carolina Ramonda, Jorge E Lauxmann, Cesar A Romero, Valeria L Vukelic, Carolina Martinatto, Belén Barrón, Pablo A Novoa, Aldo J Peixoto, Marcelo Orías

J Bras Nefrol. 2012 Jun;34(2):148-52.

PMID: 22850916

Abstract:

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.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP100643718-A	Desloratidine		100643-71-8	Price