Title

The Role of Ondansetron in the Management of Cholestatic or Uremic Pruritus—A Systematic Review

Document Type

Major Review

Publication Date

2012

Abstract

Context: Pruritus associated with hepatic or renal failure can be a troublesome symptom, refractory to treatment and associated with significant physical and emotional distress and a reduction in quality of life for patients already burdened with chronic disease. Serotonin has been implicated as a possible pathological mediator, and, therefore, 5HT3 antagonists have been suggested as a possible therapeutic intervention.

Objectives: This review of the literature systematically explores the role of ondansetron in the management of cholestatic or uremic pruritus.

Methods: Electronic databases were systematically searched for randomized controlled trials examining the role of ondansetron in cholestatic or uremic pruritus between 1966 and 2008.

Results: Five randomized controlled trials were included in this systematic review: three for cholestatic pruritus and two for uremic pruritus. All trials examined ondansetron vs. placebo, with differing treatment protocols. Overall, three studies showed no benefit to ondansetron over placebo; however, two studies in cholestatic pruritus showed small reductions in pruritus with questionable clinical significance.

Conclusion: Ondansetron was demonstrated to have negligible effect on cholestatic or uremic pruritus on the basis of a limited number of studies.

Comments

Due to copyright restrictions the publisher's version/PDF of this article is unavailable for download.

Staff and Students of the University of Notre Dame Australia may access the full text of this article here

This article may be accessed from the publisher here

The Journal of Pain and Symptom Management may be accessed from the National Library of Australia here

The Author:

Associate Professor Lawrence Lam


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