Low dose naloxone for pruritus in systemic sclerosis: Case series and literature review

Medicine (Baltimore). 2022 Jan 28;101(4):e28653. doi: 10.1097/MD.0000000000028653.

Abstract

Rationale: Pruritus is a common symptom in patients with systemic sclerosis and has a tremendous effect on the quality of life. Nevertheless, current therapeutic options are limited. The pathogenesis of pruritus in systemic sclerosis is not completely understood; however, opiate-mediated neurotransmission has been postulated to be involved.

Patient concerns and diagnosis: We describe 4 female patients with systemic sclerosis suffering from severe pruritus, with an average 5D-itch score of 22.75.

Intervention and outcomes: Low-dose oral naloxone was initiated, followed by a significant improvement in the level of pruritus, reaching an average 5D-itch score of 7.5, after 6 and 12 months of treatment. None of the patients experienced side effects.

Lessons: Low-dose naloxone plays an important role in the management of pruritus in systemic sclerosis.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / therapeutic use
  • Female
  • Humans
  • Middle Aged
  • Naloxone / administration & dosage*
  • Naloxone / therapeutic use
  • Pruritus / drug therapy*
  • Pruritus / etiology
  • Quality of Life
  • Scleroderma, Systemic / complications*

Substances

  • Analgesics, Opioid
  • Naloxone