Kidney Week 2019 — Difelikefalin reduces itching in hemodialysis patients


  • Marielle Fares, Pharm.D.
  • Conference Reports
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Takeaway

  • Difelikefalin (DFK) reduced itching in patients undergoing dialysis 3 times more than placebo, with significant improvement in QoL.
  • DFK was well-tolerated and represents an option for the treatment of pruritus in hemodialysis patients.

Why this matters

  • Uremic pruritus is prevalent in hemodialysis patients, with no effective treatment.
  • DFK is a novel, peripheral kappa opioid receptor-specific agonist for the treatment of pruritus.

Study design

  • Patients (n=377) were randomly assigned to receive DFK 0.5 mcg/kg or placebo 3 times weekly for 12 weeks.
  • The primary endpoint was the proportion of patients achieving ≥3 points improvement from baseline to week 12, in weekly mean 24-hour worst itching intensity numerical rating scale (WI-NRS) scores.
  • Secondary endpoints included change in itch-related QoL measured by patient questionnaires and the proportion of patients achieving ≥4 point improvement in WI-NRS score.

Key results

  • Significantly more patients in the DFK than placebo groups had a ≥3 point improvement (51% vs 28%, respectively; P<.001 or in wi-nrs score and a point improvement vs p reflecting change itch-related qol.>
  • Improvement with DFK was detected starting week 1, and QoL measures improved significantly (P<.001>
  • Most common adverse events in both groups were diarrhea, dizziness, and vomiting.