Treatments for Uremic Pruritus Underway

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Cara Therapeutics (Stamford, CT) released positive data about its uremic pruritus product, intravenous CR845, which targets peripheral kappa opioid receptors.

Cara noted that Part A of the Phase 2/3 trial achieved reduced itching and improved quality of life, the trial’s primary and secondary endpoints. The company intends to meet with the US Food and Drug Administration to finalize clinical study design for Part B of the trial as well as begin patient enrollment later in 2017, noted Cara Therapeutics President and Chief Executive Officer Derek Chalmers, PhD. Part B will include up to 240 participants and involve CR845 treatments just after each patient undergoes dialysis.

Other therapies for uremic pruritus are available or under development. In 2016, the Canadian Journal of Kidney Health and Disease published a review of the efficacy of gabapentin. The authors found the drug effective for uremic pruritus but noted “adverse events are common.” They advised starting at a low dose of 100 mg orally after hemodialysis and titrating to the desired effect to provide safe and effective outcomes (Lau T, et al. Gabapentin for uremic pruritus in hemodialysis patients: a qualitative systematic review. Can J Kidney Health Dis 2016; 3:14).

Another drug, pregabalin, also is under study. An observational, longitudinal study was conducted to assess the effectiveness of 75 mg pregabalin posthemodialysis for treatment-resistant uremic pruritus. The team saw a reduction of 12 points based on the 5D-Itching scale on day 2 after using pregabalin (Khan TM, Aziz A, Suleiman AK. Effectiveness of posthemodialysis administration of pregabalin (75 mg) in treatment resistant uremia pruritus, 2016; 8:74–76).

Other therapies for uremic pruritus include systemic ultraviolet light and oral antihistamines.