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Chronic Pruritus: Current and Emerging Treatment Options

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Abstract

Chronic pruritus remains a central societal issue because of its high occurrence and the substantial decrease in quality of life it may cause to affected individuals. Not only dermatological conditions, but also systemic, neurological, or psychiatric diseases may lead to chronic pruritus. Additionally, various underlying conditions may coexist or the cause may be unknown. Due to its heterogeneity, the therapeutic approach is complex and remains a challenge for the clinician. Basic measures such as emollients to avoid xerosis and treatment of the underlying disease should be initiated regardless of the duration of the symptom. Depending on the indication, other topical (e.g., calcineurin inhibitors, topical corticosteroids, capsaicin) and systemic agents (immunosuppressive drugs, gabapentinoids, antidepressants, mu-opioid receptor antagonists) may provide further relief. Additionally, accompanying disorders such as sleep impairment, depression, or anxiety should also be treated. New insights into pathways involved in the development and maintenance of chronic pruritus have led in the past years to the development of a considerable number of novel antipruritic drugs. Several randomized controlled trials have been recently completed or are currently underway testing biological compounds with promising approaches. These include antagonists for nerve growth factor, neuropeptides, histamine 4 receptors, certain interleukin receptors, and opioid receptors.

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Authors and Affiliations

  1. Department of Dermatology, Center for Chronic Pruritus, University Hospital Münster, Von-Esmarch-Str. 58, Münster, 48149, Germany

    Manuel P. Pereira & Sonja Ständer

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  1. Manuel P. Pereira
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  2. Sonja Ständer
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Correspondence to Sonja Ständer.

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Funding

This article was supported by the German Federal Ministry of Education and Research (BMBF; No. 01KG1305 to SS), the Interdisciplinary Center for Clinical Research (IZKF; No. CTRP 07 to SS), and by the European Academy for Dermatology and Venereology (EADV, No. 2016-012 to MPP).

Conflict of interest

MPP declares that he has no conflicts of interest that are directly relevant to the content of this article. SS has consulted for Beiersdorf, Galderma, Helsinn, Menlo, Nerre, and Trevi.

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Pereira, M.P., Ständer, S. Chronic Pruritus: Current and Emerging Treatment Options. Drugs 77, 999–1007 (2017). https://doi.org/10.1007/s40265-017-0746-9

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