Comparison of Sertraline with Pregabalin in the management of uremic pruritus

Abstract

Itching is one of the symptoms of skin diseases and a common symptom in some systemic diseases such as myeloproliferative malignancies, liver and biliary diseases, psychological and neurological. Itching is also seen in many chronic uremic patients and its prevalence is high at about 28%. The aim of this study was to compare the efficacy of sertraline with pregabalin in patients with uremic pruritus. Materials and Methods: This cross-sectional study was performed on 60 patients with chronic renal failure who had uremic pruritus and did not respond to emulsion and antihistamine treatment for 2 months. These patients routinely receive two pregabalin or sertraline treatments based on clinical condition and therapeutic indications at the dermatologist. Patients were divided into two groups of treatment with pregabalin and sertraline. Patients are routinely followed up for 12 weeks and the results are recorded in the patient file. Pruritis VAS score and Pruritis grading system for all patients were recorded at the beginning of the study and then at visits every two weeks and its changes in each group were evaluated and compared between the two groups. The possible side effects of treatment in both groups were also evaluated and recorded. Results: The mean age was 47.05±14.94 years (20-70 years) and 50% of them were male. There was no statistically significant difference in terms of demographic variables between the two study groups and the patients were identical. At baseline in both groups, most patients had serum creatinine levels above 5 mg / dL. In terms of treatment complications, in general, complications were observed in 30% of patients, the highest rate of which was related to dizziness and related to patients receiving pregabalin. At the beginning of the study, the patients receiving the pregabalin group had a mean score of Pruritus VAS 5.76±2.57 and the sertraline group had a mean score of 5.60±5.51. At the end of the 12th week, it was observed that the mean score in patients receiving pregabalin decreased to 1.60±1.69 (p=0.001), but no significant decrease was observed in the group receiving sertraline (p=0.278) and was equal to 4.66±1.07. In addition, evaluation of the Pruritus grading system score in the pregabalin group showed that the use of the drug significantly reduced the severity of uremic pruritus (p=0.001).