• Timothy H M To, Katherine Clark, Lawrence Lam, Tania Shelby-James, and David Christopher Currow.
• Discipline, Palliative & Supportive Services, Flinders University, Daw Park, South Australia, Australia.
• J Pain Symptom Manage. 2012 Nov 1;44(5):725-30.

ContextPruritus associated with hepatic or renal failure can be a troublesome symptom, refractory to treatment and associated with significant physical and emotional distress and a reduction in quality of life for patients already burdened with chronic disease. Serotonin has been implicated as a possible pathological mediator, and, therefore, 5HT(3) antagonists have been suggested as a possible therapeutic intervention.ObjectivesThis review of the literature systematically explores the role of ondansetron in the management of cholestatic or uremic pruritus.MethodsElectronic databases were systematically searched for randomized controlled trials examining the role of ondansetron in cholestatic or uremic pruritus between 1966 and 2008.ResultsFive randomized controlled trials were included in this systematic review: three for cholestatic pruritus and two for uremic pruritus. All trials examined ondansetron vs. placebo, with differing treatment protocols. Overall, three studies showed no benefit to ondansetron over placebo; however, two studies in cholestatic pruritus showed small reductions in pruritus with questionable clinical significance.ConclusionOndansetron was demonstrated to have negligible effect on cholestatic or uremic pruritus on the basis of a limited number of studies.Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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