THALIDOMIDE FOR THE TREATMENT OF UREMIC PRURITUS - A CROSSOVER RANDOMIZED DOUBLE-BLIND TRIAL

Our observation that thalidomide administration to a dialysis patient with leprosy alleviated his pruritus led us to condut this short-term study to assess the efficacy of the drug in this regard. From 210 hemo dialysis patients, 29 cases of refractory uremic pruritus were entered into the study. Patients were instructed to score their symptoms from 0 to 3, three times a day and assigned to receive thalidomide or plac ebo at bed time for 7 days. After a washout period of 7 days, drugs we re crossed over. Response was defined as a reduction of at least 50% i n the pruritus scoring. Eigtheen patients finished the study. In the f irst phase, 55% of patients responded showing a mean reduction in thei r pruritus scoring of 78% (p < 0.05 vs. placebo); no response to place bo was observed. A similar proportion of patients responded to thalido mide in the second phase with a mean reduction in their pruritus scori ng of 81%. In conclusion, thalidomide can be a precious tool in the ha ndling of uremic pruritus unresponsive to available therapy.