Oral nalmefene therapy reduces scratching activity due to the pruritus of cholestasis: a controlled study.

Abstract

BACKGROUND:

Intravenous naloxone frequently ameliorates the pruritus of cholestasis, but its low oral bioavailability precludes its use as a long-term therapy. Nalmefene is an orally bioavailable opiate antagonist.

OBJECTIVE:

We assessed the efficacy of oral nalmefene in ameliorating the pruritus of cholestasis.

METHODS:

In a prospective controlled study conducted in a tertiary referral hospital, 11 patients with generalized pruritus complicating chronic liver disease were randomized to receive either nalmefene or placebo in a double-blinded fashion for 2-month periods. Scratching activity was measured continuously for 24-hour periods at baseline and at the end of each treatment period.

RESULTS:

Data on 8 patients who received at least 1 course of nalmefene were available for comparison with corresponding control data, which consisted of observations obtained during a course of placebo and/or at baseline. Nalmefene therapy was associated with a 75% reduction in the geometric mean hourly scratching activity (P <.01) and a decrease in the mean of a visual analogue score of the perception of pruritus in all 8 patients (mean decrease 77%, P <.01).

CONCLUSION:

Oral administration of nalmefene can ameliorate pruritus complicating chronic liver disease.

• Authors: N V Bergasa, D W Alling, T L Talbot, M C Wells, E A Jones
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 41 Issue 3 Pt 1 Pg. 431-4 (Sep 1999) ISSN: 0190-9622 [Print] United States
• PMID: 10459118 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Antipruritics
• Narcotic Antagonists
• Tablets
• Naltrexone
• nalmefene

Topics

• Administration, Oral
• Adult
• Antipruritics (administration & dosage, adverse effects)
• Cholestasis (complications)
• Double-Blind Method
• Humans
• Naltrexone (administration & dosage, adverse effects, analogs & derivatives)
• Narcotic Antagonists (administration & dosage, adverse effects)
• Pain Measurement
• Pruritus (drug therapy, etiology)
• Tablets
• Time Factors