The KALM-1 randomized double-blind placebo-controlled phase III trial showed that intravenous difelikefalin, a selective κ-opioid receptor agonist, significantly reduces itch intensity in haemodialysis patients with uraemic pruritus. However, 49% of difelikefalin-treated patients showed no improvement. In light of the increasing number of patients with end-stage renal disease, additional treatments are sorely needed.
References
Weiss, M. et al. Prevalence of chronic itch and associated factors in haemodialysis patients: a representative cross-sectional study. Acta Derm. Venereol. 95, 816–821 (2015).
Fishbane, S. et al. A phase 3 trial of difelikefalin in hemodialysis patients with pruritus. N. Engl. J. Med. 382, 222–232 (2019).
Reich, A. et al. Itch assessment with visual analogue scale and numerical rating scale: determination of minimal clinically important difference in chronic itch. Acta Derm. Venereol. 96, 978–980 (2016).
Plewig, N. et al. The course of chronic itch in hemodialysis patients: results of a 4-year follow-up study of GEHIS (German Epidemiological Hemodialysis Itch Study). J. Eur. Acad. Derm. Venereol. 33, 1429–1435 (2019).
Riepe, C. et al. Minimal clinically important difference in chronic pruritus appears to be dependent on baseline itch severity. Acta Derm. Venereol. 99, 1288–1290 (2019).
Elman, S. et al. The 5-D itch scale: a new measure of pruritus. Br. J. Dermatol. 162, 587–593 (2010).
Weiss, M. et al. Health-related quality of life in haemodialysis patients suffering from chronic itch: results from GEHIS (German Epidemiology Haemodialysis Itch Study). Qual. Life Res. 25, 3097–3106 (2016).
Grochulska, K. et al. Mortality of haemodialysis patients with and without chronic itch: a follow-up study of the German Epidemiological Hemodialysis Itch Study (GEHIS). Acta Derm.Venereol. 99, 423–428 (2019).
Meeuwis, S. H. et al. Effects of open-and closed-label nocebo and placebo suggestions on itch and itch expectations. Front. Psychiatry 10, 436 (2019).
Cara Therapeutics. Cara Therapeutics announces positive topline data from phase 2 trial of oral KORSUVATM in chronic kidney disease patients with moderate-to-severe pruritus. Cara Therapeutics http://ir.caratherapeutics.com/news-releases/news-release-details/cara-therapeutics-announces-positive-topline-data-phase-2-trial (2019).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
E.W. is principal investigator in clinical trials sponsored by Trevi Therapeutics and Menlo Therapeutics. R.F.O. declares no competing interests.
Rights and permissions
About this article
Cite this article
Weisshaar, E., Ofenloch, R.F. One step closer to alleviating uraemic pruritus. Nat Rev Nephrol 16, 189–190 (2020). https://doi.org/10.1038/s41581-020-0251-3
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41581-020-0251-3
- Springer Nature Limited