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Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
** 99 Kumagai H. Ebata T, Takamori K et al. Effect of a novel kappareceptor agonist, nalfurafine hydrochloride, on severe itch in 337 haemodialysis patients: A Phase III, randomised, double-blind, placebo-controlled study. Neph Dialysis Transplantation. 2010;25(4) : 1251-1257.
Control of symptoms other than pain
Published in Nigel Sykes, Michael I Bennett, Chun-Su Yuan, Clinical Pain Management, 2008
Emma Hall, Nigel Sykes, Victor Pace
Nalfurafine, a novel kappa opioid agonist demonstrated benefit over placebo in 144 patients with uremic itch.171 [II] It is thought that there is imbalance between kappa and mu opioid receptors in uremic itch
Novel drugs for the treatment of chronic pruritus
Published in Expert Opinion on Investigational Drugs, 2018
Manuel P. Pereira, Sonja Ständer
Another molecule of particular interest in the treatment of CP is the kappa-opioid receptor agonist nalfurafine. Most existing data arises from RCTs on patients with uremic pruritus. Short-term (2–4 weeks) studies showed a significant itch relief by orally administered nalfurafine (2.5–5 microg daily) in hemodialysis patients [57,58]. Long-term anti-pruritic efficacy of nalfurafine (5 microg daily) in uremic pruritus and a favorable safety profile was demonstrated in an open-label study with a treatment phase of 52 weeks, and additionally, a favorable safety profile was reported [59]. Also, for cholestatic pruritus nalfurafine shows promising anti-pruritic effects with an RCT reporting a significant improvement in itch intensity in a lower (2.5 microg daily) and a higher (5 microg daily) dose regimen after 4 weeks of treatment [60], in line with retrospective analyses on this matter [61]. Other kappa-opioid receptor agonists, namely CR845, and asimadoline [62], have potentially beneficial effects in the treatment of uremic pruritus or atopic itch (NCT02475447 [63],). Specially intravenously administered CR845 seems promising for the treatment of uremic pruritus, as patients in dialysis reported a 54% greater reduction in worst itch compared to placebo by the second week of treatment [64]. A 12-week phase III RCT (NCT03422653) and the corresponding long-term extension study over 52 weeks (NCT03281538) are currently recruiting patients.
Randomized controlled trial of nalfurafine for refractory pruritus in hemodialysis patients
Published in Renal Failure, 2023
Ping Zhang, Shilong Xiang, Bicheng Liu, Xiaohui Wang, Xiaoping Yang, Chaoyang Ye, Zunsong Wang, Yanlin Li, Li Zhou, Caili Wang, Hongbo Li, Jian Huang, Ai Peng, Xiaoping Wang, Deguang Wang, Jie Xiao, Wenli Chen, Hong Cheng, Nan Mao, Jianqin Wang, Lin Yang, Jianghua Chen
In summary, the results of this prospective randomized, placebo-controlled multicenter bridging study did show efficacy of nalfurafine administration for treatment-resistant CKD-aP in Chinese population undergoing hemodialysis based on predefined criterion. The safety profile of nalfurafine was consistent with that observed in previous studies, and no new safety issues had been proposed. Nalfurafine was found to be an effective and safe treatment option for Chinese hemodialysis patients with pruritus in this study.