Effectiveness of difelikefalin in a new treatment algorithm for hemodialysis-associated pruritus: a prospective interventional study
Abstract
Background
Since
June
2009,
our
facility
has
been
using
an
internally
developed
treatment
algorithm
that
facilitates
a
comprehensive
approach
to
address
each
cause
of
hemodialysis-associated
pruritus
(HAP),
wherein
oral
nalfurafine,
selective
κ-opioid
receptor
(KOR)
agonist,
is
used
for
patients
resistant
conventional
treatments.
Upon
approval
intravenous
difelikefalin,
new
KOR
in
Japan
December
2023,
we
revised
the
algorithm.
Here,
evaluated
effectiveness
difelikefalin
Methods
Nalfurafine
was
administered
6
weeks
or
longer
43
who
were
receiving
maintenance
hemodialysis
at
order
treat
treatment-resistant
HAP
accordance
with
In
9
patients,
response
nalfurafine
considered
poor
based
on
presence
moderate
severe
daytime
nighttime
according
Shiratori
severity
score,
numerical
rating
scale
(NRS)
≥4,
despite
good
adherence
confirmed
through
history
taking.
For
those
medicine
switched
April
2024
and
16
weeks.
The
primary
endpoint
score
NRS.
secondary
endpoints
frequency
itching,
presence/absence
pruritus-related
insomnia,
satisfaction
treatment,
adverse
events.
Results
numbers
4
(44.0%)
during
(66.7%)
before
change
difelikefalin.
However,
week
after
change,
both
had
decreased
0
(0.0%)
(p
<
0.01,
p
0.001,
respectively).
median
[interquartile
range]
NRS
5
[4,
7]
which
significantly
3
[2,
3]
0.005).
number
insomnia
due
(44.4%)
0.01).
No
events
observed.
Conclusions
algorithm,
suggested
be
useful
safe
are
treatment.
Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown
Published: April 1, 2025
Language: Английский