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BioMed Research International
Volume 2017 (2017), Article ID 4790810, 6 pages
Review Article

Aprepitant for the Treatment of Chronic Refractory Pruritus

1Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
2Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA

Correspondence should be addressed to Shawn G. Kwatra

Received 7 March 2017; Revised 20 April 2017; Accepted 14 August 2017; Published 19 September 2017

Academic Editor: Adam Reich

Copyright © 2017 Alice He et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Chronic pruritus is a difficult condition to treat and is associated with several comorbidities, including insomnia, depression, and decreased quality of life. Treatment for chronic itch includes corticosteroids, antihistamines, and systemic therapies such as naltrexone, gabapentin, UV light therapy, and immunomodulatory treatments, including azathioprine, methotrexate, and cellcept. However, some patients still remain refractory to conventional therapy. Aprepitant is a neurokinin-1 receptor antagonist approved for the prevention of chemotherapy-induced and postoperative nausea and vomiting (CINV, PONV). Recently, aprepitant has demonstrated effectiveness in several case series and open label trials in relieving pruritus for patients refractory to other treatments. Patients with pruritus associated with Sézary syndrome, mycosis fungoides, lung adenocarcinoma, breast carcinoma, sarcomas, metastatic solid tumors, chronic kidney disease, hyperuricemia, iron deficiency, brachioradial pruritus, and Hodgkin’s lymphoma have experienced considerable symptom relief with short-term use of aprepitant (up to two weeks). Due to differences in reporting and evaluation of drug effects, the mechanism of aprepitant’s role is difficult to understand based on the current literature. Herein, we evaluate aprepitant’s antipruritic effects and discuss its mechanism of action and adverse effects. We propose that aprepitant is an alternative for patients suffering from pruritus who do not obtain enough symptom relief from conventional therapy.