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A randomized, placebo-controlled, double-blind trial of ondansetron in renal itch
1Department of Dermatology, South Cleveland Hospital, Middlesbrough, TS4 3BW, UK. drmichellemurphy@eircom.net
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.
Objectives:
We performed a double-blind randomized placebo-controlled trial to objectively assess the effectiveness of ondansetron in renal itch.
Patients And 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.
Insights
Ondansetron did not effectively relieve renal itch in patients with chronic kidney failure. This study found ondansetron to be no more effective than a placebo for managing pruritus in hemodialysis patients.
Area of Science:
- Nephrology
- Pharmacology
Background:
- Renal itch is a common complication in chronic renal failure patients.
- Ondansetron, a serotonin type 3 receptor antagonist, is used for chemotherapy-induced nausea.
- Anecdotal evidence suggests ondansetron may alleviate renal itch.
Purpose of the Study:
- To objectively assess the efficacy of ondansetron in treating renal itch.
- To compare ondansetron's effectiveness against a placebo in a double-blind, randomized trial.
Main Methods:
- A double-blind, placebo-controlled trial involving 24 hemodialysis patients.
- Patients received either ondansetron (8 mg thrice daily) or placebo for 2 weeks, with a crossover design.
- Pruritus severity was measured using a visual analogue scale (VAS) twice daily.
Main Results:
- Both ondansetron and placebo treatments showed a significant decrease in VAS scores.
- Pruritus decreased by 16% with ondansetron and 25% with placebo.
- More patients preferred the placebo (7 out of 11) over ondansetron.
Conclusions:
- Ondansetron demonstrated no significant benefit over placebo in controlling renal itch.
- The study concludes that ondansetron is not superior to placebo for managing pruritus in this patient group.