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Difelikefalin (Kapruvia°) in pruritus associated with chronic kidney disease

 Marketing Authorisations   Difelikefalin is the first drug to be authorised in the European Union for the treatment of moderate to severe pruritis associated with chronic kidney disease in patients on haemodialysis.
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Patients with chronic kidney disease who are undergoing haemodialysis sometimes experience major discomfort due to pruritus. One hypothesis put forward to explain the mechanism for this pruritus is an imbalance of the endogenous opioid system, with overexpression of mu opioid receptors and a concomitant underexpression of kappa receptors.

Difelikefalin, a "selective" kappa opioid receptor agonist, has been granted European marketing authorisation for use in this situation on the basis of two double-blind, randomised, placebo-controlled trials with similar protocols, carried out in 378 and 473 patients respectively.

©Prescrire 1 June 2023

Source: "Difelikefalin (Kapruvia°) in pruritus associated with chronic kidney disease" Prescrire International 2023; 32 (249): 145-148. Subscribers only.

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