The role of ondansetron in the management of cholestatic or uremic pruritus--a systematic review.

Abstract

CONTEXT:

Pruritus associated with hepatic or renal failure can be a troublesome symptom, refractory to treatment and associated with significant physical and emotional distress and a reduction in quality of life for patients already burdened with chronic disease. Serotonin has been implicated as a possible pathological mediator, and, therefore, 5HT(3) antagonists have been suggested as a possible therapeutic intervention.

OBJECTIVES:

This review of the literature systematically explores the role of ondansetron in the management of cholestatic or uremic pruritus.

METHODS:

Electronic databases were systematically searched for randomized controlled trials examining the role of ondansetron in cholestatic or uremic pruritus between 1966 and 2008.

RESULTS:

Five randomized controlled trials were included in this systematic review: three for cholestatic pruritus and two for uremic pruritus. All trials examined ondansetron vs. placebo, with differing treatment protocols. Overall, three studies showed no benefit to ondansetron over placebo; however, two studies in cholestatic pruritus showed small reductions in pruritus with questionable clinical significance.

CONCLUSION:

Ondansetron was demonstrated to have negligible effect on cholestatic or uremic pruritus on the basis of a limited number of studies.

• Authors: Timothy H M To, Katherine Clark, Lawrence Lam, Tania Shelby-James, David Christopher Currow
• Journal: Journal of pain and symptom management (J Pain Symptom Manage) Vol. 44 Issue 5 Pg. 725-30 (Nov 2012) ISSN: 1873-6513 [Electronic] United States
• PMID: 22727254 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Chemical References

• Serotonin Antagonists
• Ondansetron

Topics

• Adult
• Aged
• Aged, 80 and over
• Cholestasis (complications)
• Female
• Humans
• Male
• Middle Aged
• Ondansetron (therapeutic use)
• Pruritus (drug therapy, etiology)
• Randomized Controlled Trials as Topic
• Serotonin Antagonists (therapeutic use)
• Treatment Failure
• Uremia (complications)