Oral nalmefene therapy reduces scratching activity due to the pruritus of cholestasis: A controlled study - 07/09/11
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. (J Am Acad Dermatol 1999;41:431-4.)
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From the Liver Diseases Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases,a the Clinical Center,b the Applied Clinical Engineering Section, Biomedical Engineering and Instrumentation Program, National Center for Research Resources, c and the Department of Nursing, Clinical Center,d National Institutes of Health, Bethesda, and the Department of Gastrointestinal and Liver Diseases, Academic Medical Center, Amsterdam.e |
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Reprint requests: Nora V. Bergasa, MD, Department of Gastroenterology and Liver Disease, Beth Israel Medical Center, 1st Ave at 16th St, 18 Baird Hall, New York, NY 10003. |
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0190-9622/99/$8.00 + 0 16/1/98972 |
Vol 41 - N° 3
P. 431-434 - septembre 1999 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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