Comparing doxepin cream to oral antihistamines for the treatment of itch in burn patients: A multi-center triple-blind randomized controlled trial
| Autor: | Anouk Pijpe, H.C. Kuipers, H. Goei, A. Meij-de Vries, G.H. van Ramshorst, D. Allersma, Esther Middelkoop, Kelly A. A. Kwa, Margriet E. van Baar, W.E. Tuinebreijer, J. Hiddingh, Z.M. Rashaan, Roelf S. Breederveld, Anuschka S. Niemeijer, N. Trommel, Marianne K. Nieuwenhuis |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Erythema Visual analogue scale medicine.medical_treatment Placebo law.invention 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law lcsh:Dermatology medicine skin and connective tissue diseases business.industry lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine lcsh:RC86-88.9 General Medicine lcsh:RL1-803 Doxepin Dermatology Clemastine Antihistamine medicine.symptom Doxepin Hydrochloride business medicine.drug |
| Zdroj: | Burns Open, Vol 3, Iss 4, Pp 135-140 (2019) |
| ISSN: | 2468-9122 |
| DOI: | 10.1016/j.burnso.2019.07.003 |
| Popis: | Background: Doxepin cream, an antihistaminic agent, has shown promising results in the treatment of pruritus in burn patients. However, its effectiveness has not been studied comprehensively. Objective: To evaluate whether doxepin cream is more effective than oral antihistamines in reducing pruritus. Methods: We performed a multicenter triple-blind randomized controlled trial of twelve weeks randomizing burn patients ≥18 years with an itch intensity ≥3 on a Visual Analogue Scale (VAS) between doxepin hydrochloride 5% cream with placebo tablet or oral antihistamine (clemastine) with placebo cream. Primary endpoint was change in itch intensity. Secondary endpoints included impact of itch (Burn Itch Questionnaire), quality of life (SF-36), somnolence, and erythema (DermaSpectrometer). Results: Thirty-one (of the intended 108) subjects could be included: 13 were randomized to the doxepin and 18 to the clemastine group. The skewed distribution is attributable to the low inclusion rate. Both groups showed a significant reduction in itch intensity over a period of twelve weeks (doxepin p = 0.043, clemastine p = 0.019) with no difference between both groups in: mean itch intensity difference (p = 0.199), any of the domains (p = 0.940, p = 0.698, p = 0.859) of the Burn Itch Questionnaire, quality of life, somnolence (p = 0.143) and erythema (p = 0.796). Conclusion: The effectiveness of doxepin cream was similar to oral antihistamines in reducing itch. However, considering the study ’s limitations, a superior effect of doxepin cream cannot be completely ruled out. We recommend that future studies use a cross-over design so fewer inclusions are needed to obtain adequate power. Keywords: Itch, Pruritus, Burn, Treatment, Doxepin, Antihistamines |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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