Factors Affecting the Etiology of Intractable Pruritus in Hospitalized Patients Without Primary Skin Lesions

Akdoğan, Neslihan; Uysal, Pınar; Öktem, Ayşe; Karabulut, Erdem; Hayran, Yıldız; Yalçın, Başak

doi:10.4274/imj.galenos.2018.32068

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Further information, such as dosing, interval, and safety information, can also be gained through such preclinical studies. Experimental models of itch [ 132 ] are helpful in this regard, as clinical conditions of itch accompany several other confounding factors [ 133 ] that cannot be eliminated while studying itch mechanisms. The concept of itch models is somewhat similar to the concept of modeling other medical conditions, e.g., pain.…”

Section: Mechanisms Underlying the Antipruritic Effect Of Bontsmentioning

confidence: 99%

How Does Botulinum Toxin Inhibit Itch?

Gazerani

2022

Toxins

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Two decades after reports of the anti-pruritic effects of botulinum neurotoxins (BoNTs), there is still no approved product for the anti-itch indication of BoNTs, and most clinical case reports still focus on the off-label use of BoNTs for various itchy conditions. Few randomized clinical trials have been conducted with controversial results, and the beneficial effects of BoNTs against itch are mainly based on case studies and case series. These studies are valuable in presenting the potential application of BoNTs in chronic pruritic conditions, but due to the nature of these studies, they are categorized as providing lower levels of evidence or lower grades of recommendation. To obtain approval for the anti-pruritic indication of BoNTs, higher levels of evidence are required, which can be achieved through conducting large-scale and well-designed studies with proper control groups and established careful and reliable primary and secondary outcomes. In addition to clinical evidence, presenting the mechanism-based antipruritic action of BoNTs can potentially strengthen, accelerate, and facilitate the current efforts towards further investments in accelerating the field towards the potential approval of BoNTs for itchy conditions. This review, therefore, aimed to provide the state-of-the-art mechanisms underlying the anti-itch effect of BoNTs from basic studies that resemble various clinical conditions with itch as a hallmark. Evidence of the neuronal, glial, and immune modulatory actions of BoNTs in reducing the transmission of itch are presented, and future potential directions are outlined.

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Section: Mechanisms Underlying the Antipruritic Effect Of Bontsmentioning

confidence: 99%

How Does Botulinum Toxin Inhibit Itch?

Gazerani

2022

Toxins

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Longitudinal association between polypharmacy and development of pruritus: a Nationwide Cohort Study in a Japanese Population

Kogame

Kamitani

Yamazaki

et al. 2021

Acad Dermatol Venereol

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Background Although polypharmacy is known to cause side‐effects due to drug–drug interactions, dermatological symptoms triggered by polypharmacy are not fully addressed. Objective To investigate whether polypharmacy is associated with the risk of pruritus. Method A cohort study was performed to examine cross‐sectional and longitudinal relationships between polypharmacy and pruritus in a general population. Data were collected from the Norm Study conducted in 2016 and 2017, which is a nationwide survey based on a self‐administered questionnaire with Japanese representative participants aged 16–84 years. Presence of polypharmacy which was defined as concurrent use of ≥5 prescribed drugs. Primary outcomes were the presence of severe pruritus at baseline for the cross‐sectional analysis and the development of severe pruritus after one year for the longitudinal analysis. Multivariable modified Poisson regression analyses were performed to estimate risk ratios (RRs) and 95% confidence intervals (95%CIs) with adjustment for potential confounders (age, gender, smoking habits, drinking habits, depressive symptoms, moderate activities based on IPAQ score and presence of 11 comorbid conditions including skin disease). Results The study included 3126 participants (mean age, 48.7 years); nearly half (49.8%) were male. In all, 332 participants (10.3%) had polypharmacy in the cross‐sectional analysis. Participants with polypharmacy were more likely to present with severe pruritus at baseline than those who were not using drugs (adjusted RR = 1.52 [95%CI 1.15–2.01, P = 0.003]). The longitudinal analysis (n = 1803) was limited to those without severe pruritus at baseline; participants with polypharmacy at baseline were more likely to develop severe pruritus after a one‐year follow‐up period than those not using drugs (adjusted RR = 1.46 [95%CI 1.14–1.87, P = 0.002]). Conclusion Polypharmacy was associated with the presence of pruritus at baseline and may predict the future risk of developing pruritus.

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Factors Affecting the Etiology of Intractable Pruritus in Hospitalized Patients Without Primary Skin Lesions

Cited by 2 publications

References 17 publications

How Does Botulinum Toxin Inhibit Itch?

How Does Botulinum Toxin Inhibit Itch?

Longitudinal association between polypharmacy and development of pruritus: a Nationwide Cohort Study in a Japanese Population

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