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Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: a prospective, crossover study.

Abstract

AIM

Pruritus is common in dialysis patients. Peripheral neuropathy is also prevalent in this patient population. However, the role of neuropathy in the genesis of uraemic itch has not been adequately studied to date. Therefore, we aimed to investigate the effects of gabapentin and pregabalin on uraemic pruritus along with neuropathic pain in patients receiving haemodialysis.

METHODS

This is a 14 week long randomized, prospective, cross-over trial. Haemodialysis patients with established neuropathy and/or neuropathic pain were included. Fifty patients were randomly assigned to gabapentin 300 mg after each haemodialysis session and pregabalin 75 mg daily. After 6 weeks of treatment, cross-over was performed and patients received the other drug for another 6 weeks. Short Form of McGill Pain Questionnaire and Visual Analogue Scale were used to evaluate pain and pruritus, respectively. At each week's visit, patients were interrogated in terms of adverse effects of study drugs. Baseline laboratory data and demographic characteristics were recorded from patient charts.

RESULTS

Forty (12 males, 28 females) out of 50 patients completed the study. Mean age was 58.2 ± 13.7. Overall, 29 out of 40 patients (72.5%) had pruritus symptoms at baseline evaluation. Fifteen patients (37.5%) were diabetic. Thirty-one out of 40 patients (77.5%) had electromyography (EMG)-proven peripheral neuropathy. Twenty three patients (57.5%) had both EMG-proven neuropathy and pruritus. Gabapentin and pregabalin improved both neuropathic pain and pruritus significantly. There was no difference between the study drugs in terms of efficacy against pain and pruritus.

CONCLUSION

Treatment of neuropathic pain with either pregabalin or gabapentin effectively ameliorates uraemic itch.

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  • Authors+Show Affiliations

    ,

    Division of Nephrology, Department of Internal Medicine, Meram School of Medicine, Konya University, Meram, Konya, Turkey. yalcinsolakmd@gmail.com

    , , , , , , ,

    Source

    Nephrology (Carlton, Vic.) 17:8 2012 Nov pg 710-7

    MeSH

    Adult
    Aged
    Amines
    Analgesics
    Antipruritics
    Chi-Square Distribution
    Cross-Over Studies
    Cyclohexanecarboxylic Acids
    Electromyography
    Female
    Gabapentin
    Humans
    Male
    Middle Aged
    Neuralgia
    Pain Measurement
    Pregabalin
    Prospective Studies
    Pruritus
    Renal Dialysis
    Surveys and Questionnaires
    Time Factors
    Treatment Outcome
    Turkey
    gamma-Aminobutyric Acid

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22909343

    Citation

    Solak, Yalcin, et al. "Pregabalin Versus Gabapentin in the Treatment of Neuropathic Pruritus in Maintenance Haemodialysis Patients: a Prospective, Crossover Study." Nephrology (Carlton, Vic.), vol. 17, no. 8, 2012, pp. 710-7.
    Solak Y, Biyik Z, Atalay H, et al. Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: a prospective, crossover study. Nephrology (Carlton). 2012;17(8):710-7.
    Solak, Y., Biyik, Z., Atalay, H., Gaipov, A., Guney, F., Turk, S., ... Kanbay, M. (2012). Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: a prospective, crossover study. Nephrology (Carlton, Vic.), 17(8), pp. 710-7. doi:10.1111/j.1440-1797.2012.01655.x.
    Solak Y, et al. Pregabalin Versus Gabapentin in the Treatment of Neuropathic Pruritus in Maintenance Haemodialysis Patients: a Prospective, Crossover Study. Nephrology (Carlton). 2012;17(8):710-7. PubMed PMID: 22909343.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: a prospective, crossover study. AU - Solak,Yalcin, AU - Biyik,Zeynep, AU - Atalay,Huseyin, AU - Gaipov,Abduzhappar, AU - Guney,Figen, AU - Turk,Suleyman, AU - Covic,Adrian, AU - Goldsmith,David, AU - Kanbay,Mehmet, PY - 2012/8/23/entrez PY - 2012/8/23/pubmed PY - 2013/4/23/medline SP - 710 EP - 7 JF - Nephrology (Carlton, Vic.) JO - Nephrology (Carlton) VL - 17 IS - 8 N2 - AIM: Pruritus is common in dialysis patients. Peripheral neuropathy is also prevalent in this patient population. However, the role of neuropathy in the genesis of uraemic itch has not been adequately studied to date. Therefore, we aimed to investigate the effects of gabapentin and pregabalin on uraemic pruritus along with neuropathic pain in patients receiving haemodialysis. METHODS: This is a 14 week long randomized, prospective, cross-over trial. Haemodialysis patients with established neuropathy and/or neuropathic pain were included. Fifty patients were randomly assigned to gabapentin 300 mg after each haemodialysis session and pregabalin 75 mg daily. After 6 weeks of treatment, cross-over was performed and patients received the other drug for another 6 weeks. Short Form of McGill Pain Questionnaire and Visual Analogue Scale were used to evaluate pain and pruritus, respectively. At each week's visit, patients were interrogated in terms of adverse effects of study drugs. Baseline laboratory data and demographic characteristics were recorded from patient charts. RESULTS: Forty (12 males, 28 females) out of 50 patients completed the study. Mean age was 58.2 ± 13.7. Overall, 29 out of 40 patients (72.5%) had pruritus symptoms at baseline evaluation. Fifteen patients (37.5%) were diabetic. Thirty-one out of 40 patients (77.5%) had electromyography (EMG)-proven peripheral neuropathy. Twenty three patients (57.5%) had both EMG-proven neuropathy and pruritus. Gabapentin and pregabalin improved both neuropathic pain and pruritus significantly. There was no difference between the study drugs in terms of efficacy against pain and pruritus. CONCLUSION: Treatment of neuropathic pain with either pregabalin or gabapentin effectively ameliorates uraemic itch. SN - 1440-1797 UR - https://www.unboundmedicine.com/medline/citation/22909343/Pregabalin_versus_gabapentin_in_the_treatment_of_neuropathic_pruritus_in_maintenance_haemodialysis_patients:_a_prospective_crossover_study_ L2 - https://doi.org/10.1111/j.1440-1797.2012.01655.x DB - PRIME DP - Unbound Medicine ER -