Osaka University School of Medicine, Department of Regenerative Dermatology, 2-2, G2, Yamadaoka, Suita-shi, Osaka 5650871, Japan.
Expert Opin Pharmacother. 2012 Jul;13(10):1507-13. doi: 10.1517/14656566.2012.693164. Epub 2012 Jun 5.
Severe pruritus associated with end-stage renal disease is a particularly troublesome complication, because no effective treatment has been established. However, based on the findings of a recent randomized controlled trial, nalfurafine hydrochloride was officially approved in Japan for the treatment of resistant pruritus in hemodialysis patients.
This review is based upon a PubMed search and personal experience with nalfurafine hydrochloride. The pharmacokinetics and pharmacodynamics of nalfurafine hydrochloride are reviewed and its efficiency and potential adverse effects are discussed, mainly based on the findings of randomized controlled trials.
A recent long-term open trial showed that the effect of nalfurafine hydrochloride was enhanced by continuous, long-term administration. It will be of future interest to investigate its effect on excoriations, lichen simplex, prurigo nodularis and acquired perforating dermatosis (all caused by uremic pruritus), because it targets both the skin and the central nervous system. In clinical practice, it should be kept in mind that basic skin care with emollients and other topical drugs is essential for stopping the itch-scratch cycle, and the resultant skin barrier dysfunction.
与终末期肾病相关的严重瘙痒是一种特别麻烦的并发症，因为尚未确立有效的治疗方法。然而，基于最近一项随机对照试验的结果，盐酸那呋拉啡已在日本获得批准，用于治疗血液透析患者的顽固性瘙痒。
本文基于 PubMed 检索和个人使用盐酸那呋拉啡的经验。本文回顾了盐酸那呋拉啡的药代动力学和药效学，并根据随机对照试验的结果讨论了其疗效和潜在不良反应。
最近的一项长期开放试验表明，盐酸那呋拉啡的疗效通过持续、长期给药得到增强。未来的研究将关注其对尿毒症性瘙痒引起的抓痕、单纯性苔藓、痒疹和获得性穿孔性皮肤病的疗效，因为它既作用于皮肤又作用于中枢神经系统。在临床实践中，应牢记基础的皮肤保湿和其他局部药物治疗对于阻断瘙痒-搔抓循环及由此产生的皮肤屏障功能障碍至关重要。
