A randomized, double-blinded, vehicle-controlled clinical trial of topical cryosim-1, a synthetic TRPM8 agonist, in prurigo nodularis

BACKGROUND

Prurigo nodularis (PN) is an intensively pruritic skin disease that negatively influences quality of life. Cryosim-1 (Intrinsic IB Spot) is a synthetic, selective transient receptor potential melastatin 8 agonist.

AIMS

To investigate the efficacy and safety of cryosim-1 in PN patients.

PATIENTS/METHODS

A randomized, double-blinded, placebo-controlled clinical trial including 30 patients was conducted. The numerical rating scale (NRS) of pruritus was evaluated before and 2 h after cryosim-1 application at every visit.

RESULTS

At week 8, the mean pruritus NRS before serum application (4.7 ± 0.4 treatment, 6.1 ± 0.5 placebo; p = 0.045) and 2 h after serum application (2.8 ± 0.4 treatment, 4.3 ± 0.5 placebo; p = 0.031) were significantly lower in the treatment group, and the mean NRS for sleep disorder was significantly lower in the treatment group (2.2 ± 0.5 treatment, 4.2 ± 0.8 placebo; p = 0.031). The mean satisfaction scales for pruritus improvement were significantly higher in the treatment group (7.2 ± 0.6) than in the placebo group (4.0 ± 0.9; p = 0.005). There was no difference in TEWL between the two groups, and no adverse reactions were reported.

CONCLUSIONS

Cryosim-1 is a safe and effective topical treatment for PN patients.

Biocosmetics Made with Saccharina latissima Fractions from Sustainable Treatment: Physicochemical and Thermorheological Features

This work deals with the formulation of natural cosmetics enriched with antioxidant fractions from the ultrasound treatment (US) of the brown seaweed Saccharina latissima. The challenge was the development of a cosmetic matrix without jeopardizing the thermorheological features of the creams, adding microparticles containing the antioxidant fractions using two different carriers, mannitol and alginate. The fundamental chemical characteristics of seaweed and the extracts obtained via sonication, as well as the antioxidant properties of the latter, were analyzed. The highest TEAC (Trolox equivalent antioxidant capacity) value was identified for the extracts subjected to the longest processing time using ultrasound-assisted extraction (240 min). A similar yield of microparticle formulation (around 60%) and load capacity (about 85%) were identified with mannitol and alginate as carriers. Color testing of the creams exhibited small total color differences. The rheological results indicated that the testing temperature, from 5 to 45 °C, notably influenced the apparent viscosity of the matrices. All creams were adequately fitted with the two parameters of the Ostwald-de Waele model, with the flow consistency index following an Arrhenius dependency with the testing temperature. Neither hysteresis nor water syneresis was observed in the proposed cosmetics during 6 months of cold storage at 4-6 °C.

Gabapentin versus dexchlorpheniramine as treatment for uremic pruritus: a randomised controlled trial

BACKGROUND

Uremic pruritus is a common symptom in chronic renal failure patients with undefined pathophysiology. Initial treatment involves topical therapy mainly in the form of moisturizers, however, in many cases, this is not sufficient to relieve itching. Systemic adjuvant therapy is therefore necessary, which commonly includes oral antihistamines, with limited success. Positive effects have been reported for gabapentin.

OBJECTIVES

To evaluate the efficacy and safety of gabapentin vs. dexchlorpheniramine in reducing uremic pruritus.

MATERIALS & METHODS

A randomized, controlled, double-blinded clinical trial for haemodialysis patients with persistent pruritus was performed. Pre-randomisation, cold cream was used for 15 days by 71 participants. Those with pruritus who remained in the study (60 patients) were randomised to receive gabapentin (30 patients; GABA group) or dexchlorpheniramine (30 patients; DEX group) for 21 days. The primary outcome was the decrease in pruritus score and improvement in quality of life.

RESULTS

After cold cream use, the participants demonstrated a 37.5% median reduction in Visual Analogue Scale (p<0.01) and a 50% reduction in Quality of Life in Dermatology (DLQI) score (p<0.01). There was an additional reduction of pruritus in both groups (p<0.01), with no difference between the two (p>0.7). The median DLQI was reduced from 2 to 1 in the GABA group and from 2 to 0 in the DEX group. Nineteen patients (32%) reported mild/moderate side effects without differences between the groups.

CONCLUSIONS

Uremic pruritus was reduced upon treatment with gabapentin or dexchlorpheniramine with good safety profiles; no difference was observed between the two treatments.