Gabapentin versus narrowband ultraviolet B phototherapy versus combination of both in treatment of uremic pruritus.

BACKGROUND

Pruritus is a common skin symptom manifesting with an unpleasant sensation and desire to itch and scratch. Pruritis can be a hallmark of many skin diseases as well as other non cuatneous diseases.

AIM OF THE STUDY: To compare the efficacy of gabapentin versus narrow band UVB versus combination of both in treatment of uremic pruritus.

METHODS

This study that included 60 patients diagnosed with uremic pruritus, randomly allocated into one of three groups. Group A received oral gabapentin 300 mg OD for six weeks, group B received NB-UVB phototherapy three times per week in nonconsecutive days for a total of 18 sessions (6 weeks) and group C received combination of both therapies for 6 weeks. Efficacy was assessed by visual analogue scale (VAS) and 5-D itch scale before and after the end of therapy.

RESULTS

Significant difference of VAS score between groups A & C (P = 0.029) and between group B & C (P = 0.027) was demonstrated. Complete responders represented 55% of group C (combination treatment group), 20% of group A & only 15% of group B. The highest frequency of no response was detected for group A (30%) followed by group B (15%) and lowest for group C (5%).

CONCLUSION

Combination of both gabapentin and NB-UVB is a promising medication for the treatment of uremic pruritus. Further well-designed clinical and experimental studies are needed to clarify the relationship between the frequency of NB-UVB phototherapy sessions and gabapentin dosing for an optimal response.