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Dermatitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Allison Perz, Tara Jennings, Robert Duffy, Warren Heymann
Management: Treatment of ND typically involves high-potency topical corticosteroids, such as clobetasol. Immunomodulators, such as tacrolimus or pimecrolimus, have also been shown to be effective for some patients who do not respond to topical steroids. Oral antihistamines, such as hydroxyzine 25 mg every 6–8 hours, may be added for the antipruritic effect.
Transient Receptor Potential Channels and Itch
Published in Tian-Le Xu, Long-Jun Wu, Nonclassical Ion Channels in the Nervous System, 2021
Mahar Fatima, Jingyi Liu, Bo Duan
Cooling induced by chemicals or by cooling the temperature is shown to be anti-pruritic in the case of acute and chronic itch. Human patients with atopic dermatitis or human subjects who were given an acute histamine challenge reported relief when the temperature of the itchy skin area is cooled (98). Emerging evidence shows that TRPM8 channels are involved in cooling-mediated itch suppression.
Chlorphenoxamine
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Chlorphenoxamine is a diphenylmethane antihistamine and anticholinergic agent. It is used as an antipruritic and antiparkinsonian agent. In pharmaceutical products, chlorphenoxamine may be employed as chlorphenoxamine hydrochloride (CAS number 562-09-4, EC number 209-227-1, molecular formula C18H23Cl2NO) (1).
Current and emerging systemic treatments targeting the neural system for chronic pruritus
Published in Expert Opinion on Pharmacotherapy, 2020
Rachel Shireen Golpanian, Gil Yosipovitch
As the majority of chronic pruritus is non-histaminergic in nature, antihistamines targeting the histamine 1 receptor (H1R) traditionally commonly used for treatment of itch had minimal or no anti pruritic role. The discovery of histamine 4 receptor (H4R) has led to may represent a therapeutic target for the treatment of itch [99]. JNJ-39758979 is a selective H4R antagonist which significantly reduced pruritus in patients with AD, but two cases of agranulocytosis resulted in the trial termination [100]. Another selective H4R antagonist toreforant was not successful in reducing itch in psoriatic patients as compared to placebo [101]. Finally ZPL-3893787 significantly improved pruritus scores in a phase II trial for AD, however it did not reduce mean worst daily itch scores [102]. Phase II clinical trials are currently ongoing (NCT03517566).
An overview of drug discovery efforts for eczema: why is this itch so difficult to scratch?
Published in Expert Opinion on Drug Discovery, 2020
Kam Lun Hon, Steven Loo, Alexander K. C. Leung, Joyce T. S. Li, Vivian W. Y. Lee
In Hong Kong, Hon et al. performed a series of trials on a concoction of 5 herbs for children and young persons with AD [111–113]. Among other outcome measures, improvement of quality of life was also used [114–116]. Adverse drug reactions were generally mild, and the concoction was palatable by the children. The authors conclude that there was generally significant improvement of quality of life in these patients [111,117]. The concoction had been tested for residual pesticides, microbial products, heavy metals and considered safe [118]. The concoction underwent a double-blinded RCT in the pediatric population [119]. The investigators reported that the herbal concoction improved quality of life and spared topical steroid use in children with AD. However, antipruritic effects were not demonstrated.
Novel drugs for the treatment of chronic pruritus
Published in Expert Opinion on Investigational Drugs, 2018
Manuel P. Pereira, Sonja Ständer
Other NK1R antagonists considered for their anti-pruritic properties are tradipitant and orvepitant. In a phase II RCT tradipitant 50 mg given orally for four weeks was not superior to placebo in reducing itch intensity in patients with atopic dermatitis (NCT02004041). However, in a subsequent study, in which a higher dose (85 mg) was administered for eight weeks, significant antipruritic effects compared to placebo were recorded (NCT02651714) [53]. A large study expecting to enroll 500 patients with atopic dermatitis is ongoing and may provide important data on the anti-pruritic efficacy of this drug against atopic itch (NCT03568331). As for orvepitant, a RCT testing this drug in patients with solid tumors receiving inhibitors of anti-EGFR failed to demonstrate anti-pruritic effects of a high-dose regimen (30 mg daily) or a low-dose regimen (10 mg daily) against placebo after a treatment period of four weeks (EUCTR2013–002763–25-IT).