Cochrane Summaries

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Pharmacological interventions for pruritus in adult palliative care patients

Xander C, Meerpohl JJ, Galandi D, Buroh S, Schwarzer G, Antes G, Becker G
Published Online: 
9 June 2013

Pruritus is the medical name for itching, which can be a problem in palliative care settings where treatments for cancer or severe kidney disease are being given. In this review we looked for high quality clinical trials of drug therapies to prevent or treat itching in palliative care. We found that 30 different drugs had been tested in 40 studies, involving 1286 people with itch. There was very little information about any particular drug treatment on which to base a trustworthy assessment of whether, or how well, the different drugs worked. There was enough information to point out some possibly useful treatments for particular causes of the itch. These included indomethacin for HIV-associated itch, gabapentin and nalfurafine for itch associated with chronic kidney disease, and rifampicin and flumecinol for itch associated with liver problems. Paroxetine may be a drug of general relevance whatever the cause of the itching. The amount of information identified is too limited to say anything definite about harm. Research in palliative care is difficult and short term, but we need more good quality studies on preventing and treating itch (pruritis).