The role of ondansetron in the management of cholestatic or uremic pruritis - a systematic review
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Date
2012-11
Authors
To, Timothy H M
Clark, Katherine
Lam, Lawrence
Shelby-James, Tania Maree
Currow, David Christopher
Journal Title
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Volume Title
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© 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Abstract
Pruritus associated with hepatic or renal failure can be a troublesome symptom,
refractory to treatment, associated with significant physical and emotional distress, and
reduction in quality of life for patients already burdened with chronic disease.
Serotonin has been implicated as a possible pathological mediator, and therefore 5HT3
antagonists have been suggested as a possible therapeutic intervention.
Objectives
This review of the literature systematically explores the role of ondansetron in the
management of cholestatic or uraemic pruritus.
Methods
Electronic databases were systematically searched for randomized controlled trials
(RCTs) examining the role of ondansetron in cholestatic or uraemic pruritus between
1966 and 2008.
Results
Five RCTs were included in this systematic review: three for cholestatic pruritus, and
two for uraemic pruritus. All trials examined ondansetron versus placebo, however
with differing treatment protocols. Overall, three studies showed no benefit to
ondansetron over placebo, however two studies in cholestatic pruritus showed small
reductions in pruritus with questionable clinical significance.
Conclusion
Ondansetron was demonstrated to have negligible effect on cholestatic or uraemic
pruritus on the basis of a limited number of studies.
Description
Keywords
Palliative care
Citation
To, T.H.M., Clark, K., Lam, L., Shelby-James, T.M. and Currow, D.C., 2012. The role of ondansetron in the management of cholestatic or uremic pruritis – a systematic review. Journal of Pain and Symptom Management, 44(5), 725-730.