Sertraline usage reduces pruritus severity in hemodialysis patients

A new study published in BMC Nephrology found that sertraline treatment significantly reduced pruritus in patients compared to those who got a placebo, suggesting that sertraline may be useful in treating uremic pruritus in hemodialysis (HD) patients.

Patients with end-stage renal disease (ESRD) frequently experience the painful condition known as uremic pruritus (UP). Numerous strategies have been tried without clearly improving UP. This study was carried out by Mohamed Mamdouh Elsayed and colleagues to evaluate the impact of sertraline on UP in hemodialysis patients.

This study had 60 patients who were kept on regular HD and was a placebo-controlled, double-blinded, multicentric randomized clinical trial. Sertraline 50 mg twice a day was given to patients for 8 weeks, or a placebo. Prior to and during the period of therapy, pruritus was measured using the Visual Analogue Scale (VAS) and the 5-D Itch Scale.

The key findings of this study were:

1. The VAS score and the 5-D itch scale in the sertraline group both showed a substantial decline from baseline results at study's conclusion (p 0.001).

2. In contrast, the VAS score and 5-D scale in the placebo group both rose from baseline measures (p = 0.584 and 0.469, respectively).

3. Sertraline significantly reduced the proportion of patients with severe and very severe pruritus in both ratings, whereas the placebo group did not see a meaningful reduction [(VAS score: p = 0.739), (5-D itch scale: p = 0.763)].

4. Serum urea and serum ferritin both had significant positive relationships with the VAS and 5-D itch ratings, with p values of 0.001 and 0.002 respectively.

These findings could suggest that sertraline has a place in the management of UP. Larger, randomized clinical studies with longer follow-up times are needed to validate these findings.

Reference:

Elsayed, M. M., Elgohary, I. E., Abdelhamid, H. H. S., & Zaki, S. A. (2023). The effectiveness of sertraline in alleviating uremic pruritus in hemodialysis patients: a randomized clinical trial. In BMC Nephrology (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12882-023-03212-3