Topical gabapentin lessens itching in CKD patients

Use of topical gabapentin in the short term helps ease pruritus in patients with chronic kidney disease (CKD), with no acute adverse effects, as shown in a study.

Researchers randomized 30 patients (mean age, 43.8 years; 86.6 percent male) to treatment with topical 6% gabapentin (n=15) or plain permeation cream (n=15; control). These patients had been undergoing haemodialysis for a mean of 19.5 months, with a baseline visual analogue scale (VAS) pruritus score of ≥5.

Mean duration of pruritus was 15.8 months. The back was the primary pruritic site in the majority (83.3 percent) of the patients. Others reported the neck (n=1), buttocks (n=1), abdomen (n=1), upper arm (n=1), or thighs (n=1).

Once-daily application of 6% topical gabapentin produced a significant reduction in mean pruritus scores in the first 2 weeks of treatment, from a mean of 5.9 at baseline to 2.7 at week 1 (p<0.001) and 1.3 at week 2 (p<0.001).

Relative to the control treatment, the mean change in pruritus scores with the study drug at week 1 did not significantly differ (p=0.8). However, at week 2, the change was markedly greater with topical gabapentin than with the control (mean change, −4.6 vs −2.6; p=0.01).

There were no drug‐related adverse events reported.

More studies are needed to assess the long-term efficacy and possible late toxicities of topical gabapentin use for CKD-associated pruritus in a larger cohort of patients, the researchers said.