A randomized, placebo-controlled, double-blind trial of ondansetron in renal itch.
BACKGROUND
Renal itch is a relatively common and distressing problem for patients with chronic renal failure. Ondansetron, a serotonin type 3 receptor antagonist was developed for relief of chemotherapy induced nausea. Recently, anecdotal reports describe relief of renal itch with ondansetron.


OBJECTIVE
We performed a double-blind randomized placebo-controlled trial to objectively assess the effectiveness of ondansetron in renal itch.


METHODS
With approval from the local ethical committee, 24 patients on haemodialysis were enrolled in the trial. On a random basis 14 patients were blindly allocated to the ondansetron-placebo sequence and 10 to the placebo-ondansetron sequence. Baseline values for itch were obtained for 7 days before the treatment period and there was a 7-day washout between the treatment periods. During the treatment patients received either 8 mg of ondansetron three times a day or a placebo tablet three times a day for 2 weeks. Patients were asked to record the severity of their pruritus on a visual analogue scale (VAS) twice a day. At the end of the study patients were asked blindly which treatment they had preferred.


RESULTS
Seventeen patients completed the trial. Pruritus decreased by 16% (95% CI: 0.5-32%) during active treatment and by 25% (95% CI: 9-41%) during treatment with placebo. The change in VAS scores during treatment with ondansetron (P = 0.04) and placebo (P = 0.01) were both significant. Eleven patients expressed a preference, seven for placebo and four for ondansetron.


CONCLUSIONS
Our results show that ondansetron is no better than placebo in controlling renal itch.
Murphy
M
M
Department of Dermatology, South Cleveland Hospital, Middlesbrough, TS4 3BW, UK. drmichellemurphy@eircom.net
Reaich
D
D
Pai
P
P
Finn
P
P
Carmichael
A J
AJ
D000982:Antipruritics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology; D006435:Renal Dialysis; D016896:Treatment Outcome
D000982:Antipruritics; D017294:Ondansetron