Effect of Pregabalin versus Montelukast on TNF-alpha and IL-31 for hemodialysis patients in Iraq (A single center study)
DOI:
https://doi.org/10.60988/p.v38i3.311Abstract
Abstract:- Uremic pruritus severely impacts hemodialysis patients' quality of life. Pregabalin, a GABA derivative, inhibits neurotransmitters, while montelukast blocks leukotriene receptors. This study compares their effectiveness in alleviating this itch and analyzes their distinct impacts on inflammatory markers TNF-alpha and IL-31.
Methods: This prospective- intervention clinical trial. was conducted at the Iraqi Dialysis Center/ Medical City. Patients on hemodialysis therapy for 3 months or more with uremic pruritus randomly divided in to two groups Group P: which included 25 patients treated with pregabalin 50mg, one tablet every other day for 4 weeks
Group M: which included 25 patients treated with montelukast 10mg, one tablet every day for 4 weeks
Group control: which included 25healthy subject to assess the serum level of TNF-alpha and IL-31.
The effectiveness of the medications for each patient in group P&M was evaluated every week over four weeks using the 5-dimension itch scale, a concise questionnaire that may be easily completed its. The 5- dimension scores vary between 5 (indicating no pruritus) and 25 (representing the most severe pruritus) then Pruritus intensity measured using numeric rating scale.
The effectiveness of the medications on TNF-alpha and IL-31evaluated by taken blood sample for each patient on group P&M before treatment and after 4 weeks of treatment and compared it with control group.
Results: there is a significant (p<0.05) decrease in the 5- dimension itching score and numeric rating scale in group M after 4 weeks of treatment from the baseline score and showed a significant (p<0.05) decrease in 5- dimension itching score and numeric rating scale in group P after 4 weeks of treatment from baseline score while a comparison of the effect of montelukast and pregabalin on the 5- dimension and numeric rating scale score of uremic pruritus in hemodialysis patients was not significantly different (p>0.05). This study, showed a significant (p<0.05) decrease in the level of TNF-alpha and IL-31 in group M after 4 weeks of treatment from the baseline level and showed a significant (p<0.05) decrease in the level of TNF-alpha and IL-31 in group M after 4 weeks of treatment from the baseline level while There was no significant different (p>0.05) between two groups (M and P) in decrease of level of TNF alpha and IL-31 after four weeks of treatment. but there was a significant difference (p<0.05) then, compare the two groups with the control .
Conclusion:
Montelukast 10 mg daily or pregabalin 50 mg every other day: Effectively alleviate itching in dialysis patients with chronic kidney disease who continue to have symptoms. These medications improved pruritus compared to the baseline condition without any therapy. These two medications reduced the levels of TNF-alpha and IL-31 in hemodialysis patients. No notable disparities were detected between the two medications. The choice between these options should be individualized based on the patient's specific symptoms, overall health, and response to treatment.
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