Effect of oral naltrexone on pruritus in cholestatic patients

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:lieying97023
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AIM:To determine the efficacy and potential complica-tions of oral naltrexone used in the treatment of pruritusin cholestatic patients and to compare them with otherstudies.METHODS:Thirty-four enrolled cholestatic patientscomplaining of pruritus were studied.In the initial phase,pruritus scores during day and night were evaluated.Sub-sequently,patients were given a placebo for one weekfollowed by naltrexone for one week.In each therapeuticcourse(placebo or naltrexone)day and night pruritusscores were distinguished by a visual analogue scale(VAS)system and recorded in patients’questionnaires.RESULTS:Both naltrexone and placebo decreased VASscores significantly.Naltrexone was more effective thanplacebo in decreasing VAS scores.Both day and nightscores of pruritus decreased by half of the value priorto therapy in thirteen patients(38%).Daytime pruritusimproved completely in two patients(5.9%),but no im-provement in the nighttime values was observed in anypatient.Sixteen patients(47%)suffered from naltrexonecomplications,eleven(32%)of them were related to itswithdrawal.Complications were often mild.In the caseof withdrawal,the complication was transient(withinthe first 24-28 h of therapy)and self-limited.We had tocease the drug in two cases(5.9%)because of severewithdrawal symptoms. CONCLUSION:Naltrexone can be used in the treatmentof pruritus in cholestatic patients and is a safe drugshowing few,mild and self-limited complications. AIM: To determine the efficacy and potential complica-tions of oral naltrexone used in the treatment of pruritus in cholestatic patients and to compare them with others tudies. METHODS: Thirty-four enrolled cholestatic patients complaining of pruritus were studied.In the initial phase, pruritus scores during day and night were evaluated. Sub-sequently, patients were given a placebo for one week follow-up by naltrexone for one week. In each therapeutic course (placebo or naltrexone) day and night pruritusscores were distinguished by a visual analogue scale (VAS) system and recorded in Patients’questionnaires.RESULTS: Both naltrexone and placebo decreased VASscores significantly. Naltrexone was more effective thanplacebo in decreasing VAS scores.Both day and nightscores of pruritus decreased by half of the value priorto therapy in thirteen patients (38%). Daytime pruritusimproved completely in two patients (5.9%), but no im-provement in the nighttime values ​​was observed in anypatient. Sixteen patients (47%) suffe red from naltrexonecomplications, eleven (32%) of them were related to its withdrawal. COMPLICATIONS were often mild. in the case of withdrawal, the complication was transient (withinthe first 24-28 h of therapy) and self-limited. We had tocease the drug CONCLUSION: Naltrexone can be used in the treatment of pruritus in cholestatic patients and is a safe drugshowing few, mild and self-limited complications. in two cases (5.9%) because of severely traumatic symptoms.
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