Kuo Wu-Hsien, Chang Ko-Shih, Chang Mu-Hsin, Hsiao Yao, Tsai Ru-Yin
Department of Gastroenterology and Hepatology, Yuan Sheng-Branch, Yuan-Rung Hospital, Changhua 51052, Taiwan.
Department of Cardiology, Yuan Sheng-Branch, Yuan-Rung Hospital, Changhua 51052, Taiwan.
Int J Mol Sci. 2025 Apr 18;26(8):3840. doi: 10.3390/ijms26083840.
Chronic pruritus is a distressing condition associated with various dermatological and systemic diseases, significantly impairing patients' quality of life. While conventional treatments such as antihistamines and corticosteroids offer relief, their efficacy varies, and long-term use may lead to adverse effects. Emerging evidence suggests that certain vitamins, including vitamin D, vitamin E, vitamin B12, and niacinamide (B3), may play a role in alleviating pruritus through their anti-inflammatory, immune-regulatory, and skin barrier-enhancing properties. However, the effectiveness of these vitamins in managing chronic pruritus remains unclear. This meta-analysis aims to update and expand the evaluation of vitamin supplementation in reducing pruritus severity across different underlying conditions, extending the scope beyond vitamin D to include vitamins B and E. A comprehensive search was performed across PubMed, Embase, Web of Science, and Cochrane Library databases up to January 2025 to identify randomized controlled trials (RCTs) evaluating the effects of vitamin supplementation on chronic pruritus. A total of 21 RCTs ( = 1723) were included in the meta-analysis. Compared to placebo, vitamin supplementation demonstrated a significant reduction in pruritus severity (Standardized Mean Difference [SMD]: -0.578, 95% CI: -0.736 to -0.419, = 0.000; = 53.630, = 0.003). Subgroup analysis revealed that topical vitamin B12 and vitamin D3 showed the most pronounced antipruritic effects, particularly in patients with atopic dermatitis and chronic kidney disease-associated pruritus. Sensitivity analysis confirmed the robustness of the findings; however, potential publication bias was suggested by Egger's regression test ( = 0.00979), indicating that the overall effect may be influenced by small-study effects or underreporting of negative results. This meta-analysis indicates that vitamin B, D, and E supplementation may serve as effective adjunct therapies for managing chronic pruritus. However, the variability among the included studies highlights the necessity for well-structured, long-term RCTs to determine the ideal dosage, treatment duration, and target patient populations that would derive the greatest benefit from vitamin-based interventions.
慢性瘙痒是一种令人痛苦的病症，与多种皮肤病和全身性疾病相关，严重损害患者的生活质量。虽然抗组胺药和皮质类固醇等传统治疗方法能缓解症状，但其疗效各异，长期使用可能会导致不良反应。新出现的证据表明，某些维生素，包括维生素D、维生素E、维生素B12和烟酰胺（维生素B3），可能通过其抗炎、免疫调节和增强皮肤屏障的特性在减轻瘙痒方面发挥作用。然而，这些维生素在治疗慢性瘙痒方面的有效性仍不明确。本荟萃分析旨在更新和扩展对维生素补充剂在减轻不同潜在病症瘙痒严重程度方面的评估，将范围从维生素D扩展到包括维生素B和维生素E。截至2025年1月，在PubMed、Embase、Web of Science和Cochrane图书馆数据库中进行了全面检索，以确定评估维生素补充剂对慢性瘙痒影响的随机对照试验（RCT）。共有21项RCT（n = 1723）纳入了荟萃分析。与安慰剂相比，补充维生素可显著降低瘙痒严重程度（标准化均数差[SMD]：-0.578，95%可信区间：-0.736至-0.419，P = 0.000；I² = 53.630，P = 0.003）。亚组分析显示，局部使用维生素B12和维生素D3显示出最显著的止痒效果，尤其是在特应性皮炎和慢性肾病相关性瘙痒患者中。敏感性分析证实了研究结果的稳健性；然而，Egger回归检验提示可能存在发表偏倚（P = 0.00979），表明总体效应可能受到小样本研究效应或阴性结果报告不足的影响。本荟萃分析表明，补充维生素B、D和E可能作为治疗慢性瘙痒的有效辅助疗法。然而，纳入研究之间的变异性凸显了开展结构良好的长期RCT的必要性，以确定能从基于维生素的干预措施中获得最大益处的理想剂量、治疗持续时间和目标患者群体。
