Difelikefalin in pruritus associated with chronic kidney disease: a profile of its use
Funding The preparation of this review was not supported by any external funding.
Authorship and Conflict of interest Y. N. Lamb is a salaried employee of Adis International Ltd/Springer Nature and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.
Ethics approval, Consent to participate and consent for publication, Availability of data and material, Code availability Not applicable.
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Difelikefalin (Kapruvia®; Korsuva™), a novel peripheral kappa opioid receptor (KOR) agonist, is a promising emerging treatment for moderate-to-severe pruritus associated with chronic kidney disease (CKD) in adults undergoing haemodialysis. Evidence thus far indicates that difelikefalin is effective and generally well tolerated in these patients. In randomized, double-blind, placebo-controlled, multicentre phase 3 trials, difelikefalin produced clinically meaningful improvements in the intensity of itch in patients with moderate-to-severe CKD-associated pruritus. Difelikefalin was also associated with improved itch-related quality of life relative to placebo. Limited data suggest that clinical benefits are maintained over longer-term treatment. The most common treatment-emergent adverse events in difelikefalin recipients are diarrhoea, dizziness and nausea, typically of mild or moderate severity.
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