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Is There A New Option For Treatment Resistant Pruritis?

Pruritus, an unpleasant sensation that leads to itching, is associated with various skin disorders and can have a severe effect on quality of life. The normal age-related deterioration of skin can also lead to long-term pruritus that is difficult to treat in this population. Older patients face limitations in using oral medication due to their underlying diseases and/or possible drug interactions with their other medications. Instead of using an antihistamine agent to address one of the main mediators that produce the itching sensation, researchers sought to examine whether opiate antagonists could reduce the perception of pruritus, by modifying the neuronal sensation of itching.

In the study, sixteen patients with antihistamine-resistant pruritus received 50 mg of naltrexone per day for approximately 2 months. Patients also continued their previous therapies. After the 2-month course, patients rated their pruritus using a visual analogue scale (VAS) ranging from 0 (no pruritus) to 10 (the most intensive pruritus they can imagine). Additional evaluation was performed to check adverse drug effects. The results showed that three quarters of the patients reported their symptoms as “much improved” and 30% rated their symptoms as almost completely eliminated. The benefits were most pronounced after the first two weeks, but the overall effect at 2 months was also significant. Naltrexone relieved pruritus from various skin diseases and even itchiness associated with an internal disease, without significant side effects.

Despite contraindications for some patients (i.e. patients with drug addiction or patients who are taking opioid analgesics and/or opioid-containing medications), naltrexone could be an effective second-line option to treat pruritus in older patients.

 

Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: June 22, 2016

Source: National Center of Biotechnology Information / Annals of Dermatology
Adapted from the original article.

[Image: WikiMedia Commons]




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