A randomized, placebo-controlled, double-blind trial of ondansetron in renal itch

Michelle Murphy, D. Reaich, P. Pai, P. Finn, A. J. Carmichael

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Abstract

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.

Original languageEnglish
Pages (from-to)314-317
Number of pages4
JournalBritish Journal of Dermatology
Volume148
Issue number2
DOIs
Publication statusPublished - 1 Feb 2003

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Ondansetron
Placebos
Kidney
Pruritus
Visual Analog Scale
Therapeutics
Receptors, Serotonin, 5-HT3
Serotonin Antagonists
Nausea
Tablets
Chronic Kidney Failure
Renal Dialysis
Randomized Controlled Trials
Drug Therapy

Cite this

Murphy, Michelle ; Reaich, D. ; Pai, P. ; Finn, P. ; Carmichael, A. J. / A randomized, placebo-controlled, double-blind trial of ondansetron in renal itch. In: British Journal of Dermatology. 2003 ; Vol. 148, No. 2. pp. 314-317.
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A randomized, placebo-controlled, double-blind trial of ondansetron in renal itch. / Murphy, Michelle; Reaich, D.; Pai, P.; Finn, P.; Carmichael, A. J.

In: British Journal of Dermatology, Vol. 148, No. 2, 01.02.2003, p. 314-317.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - A randomized, placebo-controlled, double-blind trial of ondansetron in renal itch

AU - Murphy, Michelle

AU - Reaich, D.

AU - Pai, P.

AU - Finn, P.

AU - Carmichael, A. J.

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N2 - 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.

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