Table I.
Reports of cannabinoid treatment for pruritus
| Study | Study type | Type of itch | Previously attempted therapies | Cannabinoid treatment | Response | Duration of antipruritic effect | Reported side effects |
|---|---|---|---|---|---|---|---|
| Neff et al,15 2002 | Case series | Intractable cholestatic-related pruritus | Diphenhydramine, chlorpheniramine, cholestyramine, rifampicin, phenobarbital, doxepin, naltrexone, UV therapy, topical lotions, and plasmapheresis | Dronabinol 5 mg (every 8 h) | Complete resolution of itch in all 3 patients | 4-6 h | Lightheadedness in 1 patient |
| Maghfour et al, 2020 | Open-label noncomparative trial | Atopic dermatitis | NA | CBD gel | Reduction in mean POEM from baseline (16 ± 1.35) to 2 wk (8.25 ± 1.80) (P = .0007). Reduction in mean score of the emotional domain on the QOLHEQ from baseline (20.9 ± 2.06) to 2 wk (8.375 ± 1.609) (P = .004). 67% of subjects with decreased itch. 50% perceived eczema improvement | Up to 2 wk | NA |
| Visse et al, 2017 | Randomized comparative study | Xerosis-related pruritus | NA | PEA lotion twice daily for 2 wk | Reduction in pruritus intensity measured by VAS at 2 wk (P < .001) | NA | 13.3% of patients reported worsening of skin symptoms, including pruritus, singling, scaling, or reddening |
| Eberlein et al,12 2008 | Observational prospective cohort study | Atopic dermatitis-related pruritus | NA | 0.3% PEA cream twice daily for 4-6 wk | Significant clinical improvement at day 6. Continued improvement or complete resolution at 5-6 wk of treatment. Reduction of pruritus on VAS from 4.9 ± 2.6 to 2.0 ± 2.3 at study end (P < .001) | NA | Pruritus, burning, and erythema |
| Ständer et al,1 2007 | Open-label noncomparative trial | Patients with prurigo, lichen simplex, and pruritus | Topical steroids, menthol, capsaicin, tacrolimus, pimecrolimus, antihistamines, systemic steroids, naltrexone, serotonin reuptake inhibitors, and UV radiation | N-PEA cream applied for 2 wk to 6 mo | 14/22 (63.6%) reported partial or complete resolution of itch. The average reduction in itch was 86.4% as measured by VAS | NA | None reported |
| Szepietoswki et al, 2005 | Open-label noncomparative trial | Uremic pruritus | NA | PEA-containing cream twice daily for 3 wk | Complete resolution of itch in 8 patients (38.1%) on evaluation by VAS and a patient questionnaire (P < .0001) | NA | NA |
| Pulvirenti et al, 2007 | Open-label noncomparative trial | Atopic dermatitis-related pruritus | NA | Adelmidrol 2% twice daily for 4 wk | Complete resolution in 16 patients (80%) after 4 wk of treatment | NA | None reported |
| Yuan et al, 2014 | Randomized, double-blind, controlled study | Asteatotic eczema | NA | PEA 0.3% cream, AEA 0.21% cream twice daily for 28 days | 73.5% reduction in itch score at day 28 as measured by the Eczema Area and Severity Index (P < .05) | NA | None reported |
AEA, Anandamide; CBD, cannabidiol; NA, not available; PEA, palmitoylethanolamine; POEM, Patient Oriented Eczema Measure; QOLHEQ, Quality of Life Hand Eczema Questionnaire; UV, ultraviolet; VAS, visual analog scale.