Fexofenadine Versus Gabapentin for Uremic Pruritus in Patients on Regular Hemodialysis

NCT ID: NCT06466421

Last Updated: 2025-04-27

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

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-01

Study Completion Date

2024-12-20

Brief Summary

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Several studies investigated the effectiveness of Gabapentin in Uremic Pruritus (UP). No previous studies investigated the use of fexofenadine in UP. The aim of this trial is to assess the safety and possible efficacy of fexofenadine in patients with UP.

Detailed Description

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A randomized controlled single center parallel study, that will recruit 60 participants with end stage renal disease (ESRD) on regular hemodialysis (RHD) with uremic pruritus (UP). Patients will be randomized to either Fexofenadine (60 mg orally once daily), or Gabapentin (100 mg orally after each dialysis session, "thrice weekly", with titration according to response to 100 mg orally once daily). Participants will continue treatment for 3 months.

Conditions

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Uremic Pruritus Chronic Kidney Disease-associated Pruritus Hemodialysis End-stage Renal Disease Renal Replacement Therapy ESRD

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Group 1: (Gabapentin group)

30 patients will receive Gabapentin 100 mg after each dialysis session (thrice weekly). Dose may be titrated after 2 weeks, according to response and tolerability, to 100 mg orally once daily for 3 months.

Group Type ACTIVE_COMPARATOR

Gabapentin

Intervention Type DRUG

100 mg after each dialysis session (thrice weekly). Dose may be titrated after 2 weeks, according to response and tolerability, to 100 mg orally once daily for 3 months.

Group 2: (Fexofenadine group)

30 patients will receive Fexofenadine 60 mg orally once daily for 3 months.

Group Type EXPERIMENTAL

Fexofenadine

Intervention Type DRUG

Fexofenadine 60 mg orally once daily for 3 months

Interventions

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Fexofenadine

Fexofenadine 60 mg orally once daily for 3 months

Intervention Type DRUG

Gabapentin

100 mg after each dialysis session (thrice weekly). Dose may be titrated after 2 weeks, according to response and tolerability, to 100 mg orally once daily for 3 months.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years old.
* ESRD on regular hemodialysis.
* Moderate and severe Uremic Pruritus as assessed by Visual Analogue Scale.
* Able to provide an informed consent.

Exclusion Criteria

* Age \< 18 years old.
* Patients not on regular hemodialysis.
* Pruritus due to other cause.
* Cancer patients.
* Pregnancy or breastfeeding.
* Patients with history of substance abuse.
* Patients with myasthenia gravis.
* Patients who refuse or are unable to provide an informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Ihab Hosny Mohamed Elfalaha

Pharmacist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sahar M El-Haggar, PhD

Role: STUDY_CHAIR

Tanta University

Ahmed M Hussein, PhD

Role: STUDY_DIRECTOR

Helwan University

Mohamed I Hosney, PharmD

Role: PRINCIPAL_INVESTIGATOR

Tanta University

Locations

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Tanta University

Tanta, Elgharbia, Egypt

Site Status

Countries

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Egypt

References

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Yosipovitch G, Rosen JD, Hashimoto T. Itch: From mechanism to (novel) therapeutic approaches. J Allergy Clin Immunol. 2018 Nov;142(5):1375-1390. doi: 10.1016/j.jaci.2018.09.005.

Reference Type BACKGROUND
PMID: 30409247 (View on PubMed)

Verduzco HA, Shirazian S. CKD-Associated Pruritus: New Insights Into Diagnosis, Pathogenesis, and Management. Kidney Int Rep. 2020 May 8;5(9):1387-1402. doi: 10.1016/j.ekir.2020.04.027. eCollection 2020 Sep.

Reference Type BACKGROUND
PMID: 32954065 (View on PubMed)

Sukul N, Speyer E, Tu C, Bieber BA, Li Y, Lopes AA, Asahi K, Mariani L, Laville M, Rayner HC, Stengel B, Robinson BM, Pisoni RL; CKDopps and CKD-REIN investigators. Pruritus and Patient Reported Outcomes in Non-Dialysis CKD. Clin J Am Soc Nephrol. 2019 May 7;14(5):673-681. doi: 10.2215/CJN.09600818. Epub 2019 Apr 11.

Reference Type BACKGROUND
PMID: 30975656 (View on PubMed)

Smith BH, Higgins C, Baldacchino A, Kidd B, Bannister J. Substance misuse of gabapentin. Br J Gen Pract. 2012 Aug;62(601):406-7. doi: 10.3399/bjgp12X653516. No abstract available.

Reference Type BACKGROUND
PMID: 22867659 (View on PubMed)

Schricker S, Heider T, Schanz M, Dippon J, Alscher MD, Weiss H, Mettang T, Kimmel M. Strong Associations Between Inflammation, Pruritus and Mental Health in Dialysis Patients. Acta Derm Venereol. 2019 May 1;99(6):524-529. doi: 10.2340/00015555-3128.

Reference Type BACKGROUND
PMID: 30673107 (View on PubMed)

Ricardo AC, Hacker E, Lora CM, Ackerson L, DeSalvo KB, Go A, Kusek JW, Nessel L, Ojo A, Townsend RR, Xie D, Ferrans CE, Lash JP; CRIC Investigators. Validation of the Kidney Disease Quality of Life Short Form 36 (KDQOL-36) US Spanish and English versions in a cohort of Hispanics with chronic kidney disease. Ethn Dis. 2013 Spring;23(2):202-9.

Reference Type BACKGROUND
PMID: 23530302 (View on PubMed)

Park IH, Um JY, Cho JS, Lee SH, Lee SH, Lee HM. Histamine Promotes the Release of Interleukin-6 via the H1R/p38 and NF-kappaB Pathways in Nasal Fibroblasts. Allergy Asthma Immunol Res. 2014 Nov;6(6):567-72. doi: 10.4168/aair.2014.6.6.567. Epub 2014 Jul 28.

Reference Type BACKGROUND
PMID: 25374757 (View on PubMed)

Oweis AO, Al-Qarqaz F, Bodoor K, Heis L, Alfaqih MA, Almomani R, Obeidat MA, Alshelleh SA. Elevated interleukin 31 serum levels in hemodialysis patients are associated with uremic pruritus. Cytokine. 2021 Feb;138:155369. doi: 10.1016/j.cyto.2020.155369. Epub 2020 Nov 19.

Reference Type BACKGROUND
PMID: 33221158 (View on PubMed)

Oh G, Moga DC, Fardo DW, Abner EL. The association of gabapentin initiation and neurocognitive changes in older adults with normal cognition. Front Pharmacol. 2022 Nov 25;13:910719. doi: 10.3389/fphar.2022.910719. eCollection 2022.

Reference Type BACKGROUND
PMID: 36506564 (View on PubMed)

Gobo-Oliveira M, Pigari VG, Ogata MS, Miot HA, Ponce D, Abbade LP. Gabapentin versus dexchlorpheniramine as treatment for uremic pruritus: a randomised controlled trial. Eur J Dermatol. 2018 Aug 1;28(4):488-495. doi: 10.1684/ejd.2018.3356.

Reference Type BACKGROUND
PMID: 29976533 (View on PubMed)

Fehrenbacher JC, Taylor CP, Vasko MR. Pregabalin and gabapentin reduce release of substance P and CGRP from rat spinal tissues only after inflammation or activation of protein kinase C. Pain. 2003 Sep;105(1-2):133-41. doi: 10.1016/s0304-3959(03)00173-8.

Reference Type BACKGROUND
PMID: 14499429 (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)

Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 23;2(3):e088. doi: 10.5435/JAAOSGlobal-D-17-00088. eCollection 2018 Mar.

Reference Type BACKGROUND
PMID: 30211382 (View on PubMed)

Davidson S, Giesler GJ. The multiple pathways for itch and their interactions with pain. Trends Neurosci. 2010 Dec;33(12):550-8. doi: 10.1016/j.tins.2010.09.002. Epub 2010 Nov 5.

Reference Type BACKGROUND
PMID: 21056479 (View on PubMed)

Chren MM, Lasek RJ, Quinn LM, Mostow EN, Zyzanski SJ. Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Invest Dermatol. 1996 Nov;107(5):707-13. doi: 10.1111/1523-1747.ep12365600.

Reference Type BACKGROUND
PMID: 8875954 (View on PubMed)

Ningombam A, Handa S, Srivastava N, Mahajan R, De D. Addition of oral fexofenadine to topical therapy leads to a significantly greater reduction in the serum interleukin-31 levels in mild to moderate paediatric atopic dermatitis. Clin Exp Dermatol. 2022 Apr;47(4):724-729. doi: 10.1111/ced.15032. Epub 2022 Jan 6.

Reference Type BACKGROUND
PMID: 34826148 (View on PubMed)

Other Identifiers

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Fexof vs Gaba for UP in RHD

Identifier Type: -

Identifier Source: org_study_id

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