Sertraline Effect in Uremic Pruritis

NCT ID: NCT05341843

Last Updated: 2022-12-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-01

Study Completion Date

2022-10-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This study aims to assess the effect of sertraline on uremic pruritis in patients undergoing regular haemodialysis.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The reported prevalence of uremic pruritus in adult hemodialysis patients has varied over the years, and some studies suggest the prevalence may be decreasing with more effective dialysis. One of the largest trials (the Dialysis Outcomes and Practice Patterns Study \[DOPPS\]) reported that the prevalence of moderate pruritus remained constant at 18 percent until 2015.

A direct role for proinflammatory T cells and cytokines is suggested by studies that showed higher levels of proinflammatory T helper-1 (TH1) cells, C-reactive protein, interleukin-6, and interleukin-2 levels among hemodialysis patients versus those without pruritus. Also, histamine release from mast cells, other pruritogens and xerosis have been all implicated in the pathogenesis of uremic pruritus.

Less convincing associations have also been made to anemia, male sex, increased beta-2 microglobulin levels, serotype human leukocyte antigen (HLA)-B35, and comorbidities including congestive heart failure and neurologic disease. The risk of uremic pruritis appears to be independent of ethnicity, type of dialysis, and underlying renal disease. No single cause underlying uremic pruritus has been identified. Multiple factors have been associated in observational studies, and supportive therapies that are used to treat uremic pruritus have targeted such factors.

High quality evidence on which to base recommendations for the treatment of uremic pruritus is limited. Many pharmacologic treatments have been proposed for uremic pruritis through different clinical trials. However, the results were quite variable and most of these studies were small uncontrolled trials and hence they were flawed.

Several studies have revealed that the selective serotonin reuptake inhibitors (SSRI) could reduce the severity of pruritus. Sertraline hydrochloride is a selective serotonin reuptake inhibitor which established improvement in itching in patients with cholestatic pruritis. This was supported by Browning et al. (2003) whose study showed 86% of subjects who had been given sertraline for another indication improved considerably with pruritus disappearing in 30% of the subjects.

Generally, most of the previous research has tended to focus on cholestatic pruritis rather than uremic pruritis. Although enough is known to determine a reasonable approach to a patient with uremic pruritus, more research is needed to understand the pathophysiology of this condition and to establish more reliable treatments. Hence, this study is organized in an attempt to find out the effect of sertraline on alleviation of uremic pruritus.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Uremic Pruritis

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

sertraline, hemodialysis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This research is a double-blinded randomized multicentric clinical trial in which 50 haemodialysis patients will be randomly assigned to one of the study groups using block randomization with a ratio of 1:1.

* Group A: 25 patients will receive sertraline at the intended dose of 50 mg twice daily for 8 weeks.
* Group B: 25 patients will receive a placebo.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
a double blinded study as participants, health care providers as well as the outcome assessor will be unaware about the type of treatment each patient receive.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

sertraline

they will receive sertraline at the intended dose of 50 mg twice daily for 8 weeks.

Group Type EXPERIMENTAL

sertraline

Intervention Type DRUG

sertraline at the intended dose of 50 mg twice daily for 8 weeks.

placebo

They will receive a placebo in the form of multivitamin tablets similar to the experimental drug with the same regimen, as one tablet /day for 8 weeks

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

a placebo in the form of multivitamin tablets similar to the experimental drugs with the same regimen (one tablet /day for 8 weeks)

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

sertraline

sertraline at the intended dose of 50 mg twice daily for 8 weeks.

Intervention Type DRUG

placebo

a placebo in the form of multivitamin tablets similar to the experimental drugs with the same regimen (one tablet /day for 8 weeks)

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. ≥1 month of maintenance haemodialysis, 3 times per week for 4 hours.
2. Adult patients with ages between 18-80 years.

Exclusion Criteria

1. Primary skin diseases (eczema, psoriasis, allergic dermatitis or drug rash).
2. Peripheral neuropathy, thyroid disease, leukemia, lymphoma, liver disease, Systemic lupus erythematosus or pregnancy.
3. Patients who consumed emollients cream, antihistamine, opioid antagonist, immunosuppressants, cholestyramine, corticosteroids or UVB phototherapy 1 month before study.
4. calcium X phosphorus (Ca X P) \>55.0 mg/dl, P \>5.5 mg/dl, parathyroid hormone (PTH) \>450 pg/ml.
5. Selective serotonin reuptake inhibitors intolerance.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Alexandria University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Mohamed Mamdouh Mahmoud Mohamed Elsayed , MD

Lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Mohamed Mamdouh Elsayed, MD

Role: PRINCIPAL_INVESTIGATOR

lecturer

Sherif aziz Zaki, MD

Role: STUDY_CHAIR

professor

Iman ezzat El Gohary, MD

Role: STUDY_CHAIR

professor

Heidi Hesham Abd El Hamid, MBBCh

Role: STUDY_CHAIR

Resident

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Faculty of Medicine, Aexandria University

Alexandria, , Egypt

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Egypt

References

Explore related publications, articles, or registry entries linked to this study.

Patel TS, Freedman BI, Yosipovitch G. An update on pruritus associated with CKD. Am J Kidney Dis. 2007 Jul;50(1):11-20. doi: 10.1053/j.ajkd.2007.03.010.

Reference Type BACKGROUND
PMID: 17591521 (View on PubMed)

Pisoni RL, Wikstrom B, Elder SJ, Akizawa T, Asano Y, Keen ML, Saran R, Mendelssohn DC, Young EW, Port FK. Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2006 Dec;21(12):3495-505. doi: 10.1093/ndt/gfl461. Epub 2006 Sep 12.

Reference Type BACKGROUND
PMID: 16968725 (View on PubMed)

Pauli-Magnus C, Mikus G, Alscher DM, Kirschner T, Nagel W, Gugeler N, Risler T, Berger ED, Kuhlmann U, Mettang T. Naltrexone does not relieve uremic pruritus: results of a randomized, double-blind, placebo-controlled crossover study. J Am Soc Nephrol. 2000 Mar;11(3):514-519. doi: 10.1681/ASN.V113514.

Reference Type BACKGROUND
PMID: 10703675 (View on PubMed)

Rayner HC, Larkina M, Wang M, Graham-Brown M, van der Veer SN, Ecder T, Hasegawa T, Kleophas W, Bieber BA, Tentori F, Robinson BM, Pisoni RL. International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis. Clin J Am Soc Nephrol. 2017 Dec 7;12(12):2000-2007. doi: 10.2215/CJN.03280317. Epub 2017 Sep 18.

Reference Type BACKGROUND
PMID: 28923831 (View on PubMed)

Kimmel M, Alscher DM, Dunst R, Braun N, Machleidt C, Kiefer T, Stulten C, van der Kuip H, Pauli-Magnus C, Raub U, Kuhlmann U, Mettang T. The role of micro-inflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. Nephrol Dial Transplant. 2006 Mar;21(3):749-55. doi: 10.1093/ndt/gfi204. Epub 2005 Oct 25.

Reference Type BACKGROUND
PMID: 16249205 (View on PubMed)

Fallahzadeh MK, Roozbeh J, Geramizadeh B, Namazi MR. Interleukin-2 serum levels are elevated in patients with uremic pruritus: a novel finding with practical implications. Nephrol Dial Transplant. 2011 Oct;26(10):3338-44. doi: 10.1093/ndt/gfr053. Epub 2011 Mar 3.

Reference Type BACKGROUND
PMID: 21372257 (View on PubMed)

Charlesworth EN, Beltrani VS. Pruritic dermatoses: overview of etiology and therapy. Am J Med. 2002 Dec 16;113 Suppl 9A:25S-33S. doi: 10.1016/s0002-9343(02)01434-1.

Reference Type BACKGROUND
PMID: 12517579 (View on PubMed)

Stander S, Bockenholt B, Schurmeyer-Horst F, Weishaupt C, Heuft G, Luger TA, Schneider G. Treatment of chronic pruritus with the selective serotonin re-uptake inhibitors paroxetine and fluvoxamine: results of an open-labelled, two-arm proof-of-concept study. Acta Derm Venereol. 2009;89(1):45-51. doi: 10.2340/00015555-0553.

Reference Type BACKGROUND
PMID: 19197541 (View on PubMed)

Mayo MJ, Handem I, Saldana S, Jacobe H, Getachew Y, Rush AJ. Sertraline as a first-line treatment for cholestatic pruritus. Hepatology. 2007 Mar;45(3):666-74. doi: 10.1002/hep.21553.

Reference Type BACKGROUND
PMID: 17326161 (View on PubMed)

Snit M, Gawlik R, Lacka-Gazdzik B, Kuzniewicz R, Dwornicki M, Owczarek A, Walaszczyk M, Grabiec P, Grzeszczak W. Substance P and intensity of pruritus in hemodialysis and peritoneal dialysis patients. Med Sci Monit. 2013 Sep 2;19:723-32. doi: 10.12659/MSM.889349.

Reference Type BACKGROUND
PMID: 23995243 (View on PubMed)

Ko MJ, Wu HY, Chen HY, Chiu YL, Hsu SP, Pai MF, Ju-Yehyang, Lai CF, Lu HM, Huang SC, Yang SY, Wen SY, Chiu HC, Hu FC, Peng YS, Jee SH. Uremic pruritus, dialysis adequacy, and metabolic profiles in hemodialysis patients: a prospective 5-year cohort study. PLoS One. 2013 Aug 6;8(8):e71404. doi: 10.1371/journal.pone.0071404. Print 2013.

Reference Type BACKGROUND
PMID: 23940749 (View on PubMed)

Wu HY, Peng YS, Chen HY, Tsai WC, Yang JY, Hsu SP, Pai MF, Lu HM, Chiang JF, Ko MJ, Wen SY, Chiu HC. A Comparison of Uremic Pruritus in Patients Receiving Peritoneal Dialysis and Hemodialysis. Medicine (Baltimore). 2016 Mar;95(9):e2935. doi: 10.1097/MD.0000000000002935.

Reference Type BACKGROUND
PMID: 26945400 (View on PubMed)

Elman S, Hynan LS, Gabriel V, Mayo MJ. The 5-D itch scale: a new measure of pruritus. Br J Dermatol. 2010 Mar;162(3):587-93. doi: 10.1111/j.1365-2133.2009.09586.x. Epub 2009 Dec 1.

Reference Type BACKGROUND
PMID: 19995367 (View on PubMed)

Elsayed MM, Elgohary IE, Abdelhamid HHS, Zaki SA. The effectiveness of sertraline in alleviating uremic pruritus in hemodialysis patients: a randomized clinical trial. BMC Nephrol. 2023 Jun 3;24(1):155. doi: 10.1186/s12882-023-03212-3.

Reference Type DERIVED
PMID: 37270517 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

sertraline and uremic pruritis

Identifier Type: -

Identifier Source: org_study_id