Gabapentin versus narrowband ultraviolet B phototherapy versus combination of both in treatment of uremic pruritus.

Background: Pruritus is a common skin symptom manifesting with an unpleasant sensation and desire to itch and scratch. Pruritis can be a hallmark of many skin diseases as well as other non cuatneous diseases.

Aim Of The Study: To compare the efficacy of gabapentin versus narrow band UVB versus combination of both in treatment of uremic pruritus.

Methods: This study that included 60 patients diagnosed with uremic pruritus, randomly allocated into one of three groups. Group A received oral gabapentin 300 mg OD for six weeks, group B received NB-UVB phototherapy three times per week in nonconsecutive days for a total of 18 sessions (6 weeks) and group C received combination of both therapies for 6 weeks. Efficacy was assessed by visual analogue scale (VAS) and 5-D itch scale before and after the end of therapy.

Results: Significant difference of VAS score between groups A & C (P = 0.029) and between group B & C (P = 0.027) was demonstrated. Complete responders represented 55% of group C (combination treatment group), 20% of group A & only 15% of group B. The highest frequency of no response was detected for group A (30%) followed by group B (15%) and lowest for group C (5%).

Conclusion: Combination of both gabapentin and NB-UVB is a promising medication for the treatment of uremic pruritus. Further well-designed clinical and experimental studies are needed to clarify the relationship between the frequency of NB-UVB phototherapy sessions and gabapentin dosing for an optimal response.