AzTrials
AzTrials

Uremic PruritisPhase 2NCT05341843

Sertraline Effect in Uremic Pruritis

A Phase 2 study testing sertraline in people with Uremic Pruritis, run by Alexandria University at 1 site in Egypt.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study aims to assess the effect of sertraline on uremic pruritis in patients undergoing regular haemodialysis. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Uremic Pruritis
What is being tested?
sertraline
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteEgypt
Study dates
1 May 2022to 1 Oct 2022
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥1 month of maintenance haemodialysis, 3 times per week for 4 hours.
  • Adult patients with ages between 18-80 years.

Who cannot join

  • Primary skin diseases (eczema, psoriasis, allergic dermatitis or drug rash).
  • Peripheral neuropathy, thyroid disease, leukemia, lymphoma, liver disease, Systemic lupus erythematosus or pregnancy.
  • Patients who consumed emollients cream, antihistamine, opioid antagonist, immunosuppressants, cholestyramine, corticosteroids or UVB phototherapy 1 month before study.
  • calcium X phosphorus (Ca X P) >55.0 mg/dl, P >5.5 mg/dl, parathyroid hormone (PTH) >450 pg/ml.
  • Selective serotonin reuptake inhibitors intolerance.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Faculty of Medicine, Aexandria University

    Alexandria, 21526

Other trials in Egypt

About this study

Official title: Effectiveness of Sertraline in Alleviating Uremic Pruritis in Hemodialysis Patients

This study aims to assess the effect of sertraline on uremic pruritis in patients undergoing regular haemodialysis.

Read the detailed description

The reported prevalence of uremic pruritus in adult hemodialysis patients has varied over the years, and some studies suggest the prevalence may be decreasing with more effective dialysis. One of the largest trials (the Dialysis Outcomes and Practice Patterns Study [DOPPS]) reported that the prevalence of moderate pruritus remained constant at 18 percent until 2015.

A direct role for proinflammatory T cells and cytokines is suggested by studies that showed higher levels of proinflammatory T helper-1 (TH1) cells, C-reactive protein, interleukin-6, and interleukin-2 levels among hemodialysis patients versus those without pruritus. Also, histamine release from mast cells, other pruritogens and xerosis have been all implicated in the pathogenesis of uremic pruritus.

Less convincing associations have also been made to anemia, male sex, increased beta-2 microglobulin levels, serotype human leukocyte antigen (HLA)-B35, and comorbidities including congestive heart failure and neurologic disease. The risk of uremic pruritis appears to be independent of ethnicity, type of dialysis, and underlying renal disease. No single cause underlying uremic pruritus has been identified. Multiple factors have been associated in observational studies, and supportive therapies that are used to treat uremic pruritus have targeted such factors.

High quality evidence on which to base recommendations for the treatment of uremic pruritus is limited. Many pharmacologic treatments have been proposed for uremic pruritis through different clinical trials. However, the results were quite variable and most of these studies were small uncontrolled trials and hence they were flawed.

Several studies have revealed that the selective serotonin reuptake inhibitors (SSRI) could reduce the severity of pruritus. Sertraline hydrochloride is a selective serotonin reuptake inhibitor which established improvement in itching in patients with cholestatic pruritis. This was supported by Browning et al. (2003) whose study showed 86% of subjects who had been given sertraline for another indication improved considerably with pruritus disappearing in 30% of the subjects.

Generally, most of the previous research has tended to focus on cholestatic pruritis rather than uremic pruritis. Although enough is known to determine a reasonable approach to a patient with uremic pruritus, more research is needed to understand the pathophysiology of this condition and to establish more reliable treatments. Hence, this study is organized in an attempt to find out the effect of sertraline on alleviation of uremic pruritus.

Conditions
Uremic Pruritis
Being tested
sertraline, placebo
Keywords
sertraline, hemodialysis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • sertralineDrug

    sertraline at the intended dose of 50 mg twice daily for 8 weeks.

  • placeboDrug

    a placebo in the form of multivitamin tablets similar to the experimental drugs with the same regimen (one tablet /day for 8 weeks)

Study groups in NCT05341843
Study groupRoleWhat they receive
sertralineExperimentalthey will receive sertraline at the intended dose of 50 mg twice daily for 8 weeks.
Receives: Drug: sertraline
placeboPlacebo comparatorThey will receive a placebo in the form of multivitamin tablets similar to the experimental drug with the same regimen, as one tablet /day for 8 weeks
Receives: Drug: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. change in uremic pruritis intensity

    Assessment of pruritis will be done before and after the course of treatment (8 weeks) through the following scores:

    1. Visual analogue scale (VAS) II) 5D itch scale

    Measured: 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Apr 2022
  2. Study start1 May 2022
  3. Primary completion1 Sep 2022
  4. Study completion1 Oct 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This research is a double-blinded randomized multicentric clinical trial in which 50 haemodialysis patients will be randomly assigned to one of the study groups using block randomization with a ratio of 1:1. * Group A: 25 patients will receive sertraline at the intended dose of 50 mg twice daily for 8 weeks. * Group B: 25 patients will receive a placebo.
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05341843
Sponsor's protocol ID
sertraline and uremic pruritis
Status last verified
Dec 2022
First submitted
18 Apr 2022
Last updated
14 Dec 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Patel TS, Freedman BI, Yosipovitch G. An update on pruritus associated with CKD. Am J Kidney Dis. 2007 Jul;50(1):11-20. doi: 10.1053/j.ajkd.2007.03.010.

    PubMed 17591521
  • Pisoni RL, Wikstrom B, Elder SJ, Akizawa T, Asano Y, Keen ML, Saran R, Mendelssohn DC, Young EW, Port FK. Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2006 Dec;21(12):3495-505. doi: 10.1093/ndt/gfl461. Epub 2006 Sep 12.

    PubMed 16968725
  • Pauli-Magnus C, Mikus G, Alscher DM, Kirschner T, Nagel W, Gugeler N, Risler T, Berger ED, Kuhlmann U, Mettang T. Naltrexone does not relieve uremic pruritus: results of a randomized, double-blind, placebo-controlled crossover study. J Am Soc Nephrol. 2000 Mar;11(3):514-519. doi: 10.1681/ASN.V113514.

    PubMed 10703675
  • Rayner HC, Larkina M, Wang M, Graham-Brown M, van der Veer SN, Ecder T, Hasegawa T, Kleophas W, Bieber BA, Tentori F, Robinson BM, Pisoni RL. International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis. Clin J Am Soc Nephrol. 2017 Dec 7;12(12):2000-2007. doi: 10.2215/CJN.03280317. Epub 2017 Sep 18.

    PubMed 28923831
  • Kimmel M, Alscher DM, Dunst R, Braun N, Machleidt C, Kiefer T, Stulten C, van der Kuip H, Pauli-Magnus C, Raub U, Kuhlmann U, Mettang T. The role of micro-inflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. Nephrol Dial Transplant. 2006 Mar;21(3):749-55. doi: 10.1093/ndt/gfi204. Epub 2005 Oct 25.

    PubMed 16249205
  • Fallahzadeh MK, Roozbeh J, Geramizadeh B, Namazi MR. Interleukin-2 serum levels are elevated in patients with uremic pruritus: a novel finding with practical implications. Nephrol Dial Transplant. 2011 Oct;26(10):3338-44. doi: 10.1093/ndt/gfr053. Epub 2011 Mar 3.

    PubMed 21372257
  • Charlesworth EN, Beltrani VS. Pruritic dermatoses: overview of etiology and therapy. Am J Med. 2002 Dec 16;113 Suppl 9A:25S-33S. doi: 10.1016/s0002-9343(02)01434-1.

    PubMed 12517579
  • Stander S, Bockenholt B, Schurmeyer-Horst F, Weishaupt C, Heuft G, Luger TA, Schneider G. Treatment of chronic pruritus with the selective serotonin re-uptake inhibitors paroxetine and fluvoxamine: results of an open-labelled, two-arm proof-of-concept study. Acta Derm Venereol. 2009;89(1):45-51. doi: 10.2340/00015555-0553.

    PubMed 19197541
  • Mayo MJ, Handem I, Saldana S, Jacobe H, Getachew Y, Rush AJ. Sertraline as a first-line treatment for cholestatic pruritus. Hepatology. 2007 Mar;45(3):666-74. doi: 10.1002/hep.21553.

    PubMed 17326161
  • Snit M, Gawlik R, Lacka-Gazdzik B, Kuzniewicz R, Dwornicki M, Owczarek A, Walaszczyk M, Grabiec P, Grzeszczak W. Substance P and intensity of pruritus in hemodialysis and peritoneal dialysis patients. Med Sci Monit. 2013 Sep 2;19:723-32. doi: 10.12659/MSM.889349.

    PubMed 23995243
  • Ko MJ, Wu HY, Chen HY, Chiu YL, Hsu SP, Pai MF, Ju-Yehyang, Lai CF, Lu HM, Huang SC, Yang SY, Wen SY, Chiu HC, Hu FC, Peng YS, Jee SH. Uremic pruritus, dialysis adequacy, and metabolic profiles in hemodialysis patients: a prospective 5-year cohort study. PLoS One. 2013 Aug 6;8(8):e71404. doi: 10.1371/journal.pone.0071404. Print 2013.

    PubMed 23940749
  • Wu HY, Peng YS, Chen HY, Tsai WC, Yang JY, Hsu SP, Pai MF, Lu HM, Chiang JF, Ko MJ, Wen SY, Chiu HC. A Comparison of Uremic Pruritus in Patients Receiving Peritoneal Dialysis and Hemodialysis. Medicine (Baltimore). 2016 Mar;95(9):e2935. doi: 10.1097/MD.0000000000002935.

    PubMed 26945400
  • Elman S, Hynan LS, Gabriel V, Mayo MJ. The 5-D itch scale: a new measure of pruritus. Br J Dermatol. 2010 Mar;162(3):587-93. doi: 10.1111/j.1365-2133.2009.09586.x. Epub 2009 Dec 1.

    PubMed 19995367
  • Elsayed MM, Elgohary IE, Abdelhamid HHS, Zaki SA. The effectiveness of sertraline in alleviating uremic pruritus in hemodialysis patients: a randomized clinical trial. BMC Nephrol. 2023 Jun 3;24(1):155. doi: 10.1186/s12882-023-03212-3.

    PubMed 37270517

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing sertraline in people with Uremic Pruritis, run by Alexandria University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

change in uremic pruritis intensity (time frame: 8 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05341843, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Dec 2022.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in