title: Uremic pruritus in hemodialysis patients: treatment with desloratidine versus gabapentin.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  Desloratadine provides significant relief of uremic pruritus compared with no therapy. gabapentin has marginal efficacy. Desloratadine is better tolerated than gabapentin.
authors.affiliation: Nephrology Service, Sanatorio Allende, Cordoba, Argentina. lincemar1@hotmail.com
authors.forename: Diego
authors.initials: D
authors.lastname: Marquez
authors.forename: Carolina
authors.initials: C
authors.lastname: Ramonda
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Lauxmann
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Romero
authors.forename: Valeria L
authors.initials: VL
authors.lastname: Vukelic
authors.forename: Carolina
authors.initials: C
authors.lastname: Martinatto
authors.forename: Belén
authors.initials: B
authors.lastname: Barrón
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Novoa
authors.forename: Aldo J
authors.initials: AJ
authors.lastname: Peixoto
authors.forename: Marcelo
authors.initials: M
authors.lastname: Orías
mesh_terms: D000588:Amines / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D000077206:Gabapentin; D039563:Histamine H1 Antagonists, Non-Sedating / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D017336:Loratadine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D014511:Uremia / Q000150:complications / Q000628:therapy; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D039563:Histamine H1 Antagonists, Non-Sedating; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D017336:Loratadine; C121345:desloratadine