title: Gabapentin: A promising therapy for uremic pruritus in hemodialysis patients: A randomized-controlled trial and review of literature.
abstract: BACKGROUND
  Treatment of uremic pruritus (UP) is a big challenge.
  
  
  OBJECTIVE
  To evaluate efficacy, appropriate dosing regimen and safety of gabapentin on UP in hemodialysis (HD) patients.
  
  
  METHODS
  Fifty-four uremic patients undergoing HD and complaining of UP were randomly classified into two equal groups. Gabapentin group: 27 patients received gabapentin capsules starting with 100 mg and gradually titrated up to a maximum of 300 mg after each HD session for one month. Placebo group: 27 patients received placebo thrice weekly after each HD session. Severity of pruritus was measured by visual analog scale (VAS) and 5-D pruritus scale.
  
  
  RESULTS
  In gabapentin group, 88.9% of patients responded well to gabapentin versus 22.2% in placebo group. A highly statistical difference was detected in favor of gabapentin group (p< 0.001). The frequency of the use of the lowest dose (100 mg thrice weekly) was significantly higher than other doses (p < 0.0001). Adverse effects were mild and tolerated.
  
  
  CONCLUSIONS
  Gabapentin is a promising and a well-tolerated treatment option for patients with UP. We recommend it as a first line therapy with a maintenance post-HD dose of 100-300 mg. We also recommend the 5-D scale in the assessment of the severity of pruritus.
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Eman
authors.initials: E
authors.lastname: Nofal
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Fawzia
authors.initials: F
authors.lastname: Farag
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Nofal
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Fatma
authors.initials: F
authors.lastname: Eldesouky
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Reham
authors.initials: R
authors.lastname: Alkot
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Abdelkhalik
mesh_terms: D000328:Adult; D000368:Aged; D000588:Amines / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects*; D014511:Uremia / Q000209:etiology; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
chemical_list: D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin
keywords: 5-D pruritus scale; Uremic pruritus; VAS; gabapentin; hemodialysis