The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Oral naltrexone treatment for cholestatic pruritus: A double-blind, placebo-controlled study
Open accessAbstract
Background & aims The efficacy of currently available therapeutic agents for cholestatic pruritus is often disappointing. The aim of this study was to assess the antipruritic effect of naltrexone, an oral opiate receptor antagonist. Methods Sixteen patients with pruritus of chronic cholestasis were randomized to receive naltrexone (4-week course of 50 mg naltrexone daily) or placebo. Pruritus, quality of sleep, fatigue (using visual analogue scales), side effects, and liver function were assessed every 2 weeks. Serum naltrexone and 6 beta-naltrexol concentrations in all patients and 5 healthy controls were measured during the first day of naltrexone treatment. Results Mean changes with respect to baseline were significantly different, in favor of the naltrexone group, for daytime itching (-54% vs. 8%; P < 0.001) and nighttime itching (-44% vs. 7%, P = 0.003). In 4 naltrexone-treated patients, side effects (transient in 3 cases) consistent with an opiate withdrawal syndrome were noted. No deterioration of the underlying disease was observed. Naltrexone and 6 beta-naltrexol levels did not differ between patients and controls, and there was no significant association with treatment response. Conclusions For patients with cholestatic liver disease and itching, refractory to regular antipruritic therapy, oral naltrexone may be an effective and well-tolerated alternative.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Opiate antagonists (oral naltrexone and parenteral naloxone) are increasingly used as third-line therapy as they reduce the sensation of itching and scratching activity.186 190–192”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [191]
Citations
Cites
Opioid peptides and primary biliary cirrhosis
Thornton, J. R., & Losowsky, M. S. (1988) · BMJ · doi:10.1136/bmj.297.6662.1501 · Cited by 300
Treatment of pruritus of primary biliary cirrhosis with rifampin
Podesta, A., Lopez, P., Terg, R., Villamil, F., Flores, D., Mastai, R., Udaondo, C. B., & Companc, J. P. (1991) · Digestive Diseases and Sciences · doi:10.1007/bf01300759 · Cited by 267
Effects of long-term rifampicin administration in primary biliary cirrhosis
Bachs, L., Parés, A., Elena, M., Piera, C., & Rodés, J. (1992) · Gastroenterology · doi:10.1016/0016-5085(92)90335-v · Cited by 235
Cholestyramine for long term relief of the pruritus complicating intrahepatic cholestasis
Datta, D. V., & Sherlock, S. (1966) · Gastroenterology · doi:10.1016/s0016-5085(66)80071-9 · Cited by 181
Liver transplantation: An overview
Maddrey, W. C., & Thiel, D. H. V. (1988) · Hepatology · doi:10.1002/hep.1840080440 · Cited by 154
Nalmefene: Intravenous safety and kinetics of a new opioid antagonist
Dixon, R., Howes, J. F., Gentile, J., Hsu, H., Hsiao, J. H., Garg, D. C., Weidler, D. J., Meyer, M. C., & Tuttle, R. R. (1986) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.1986.9 · Cited by 98
Pruritus in hepatic cholestasis. Pathogenesis and therapy
Garden, J. M. (1985) · Archives of Dermatology · doi:10.1001/archderm.121.11.1415 · Cited by 57
Pruritis associated with cholestasis
Khandelwal, M., & Malet, P. F. (1994) · Digestive Diseases and Sciences · doi:10.1007/bf02090052 · Cited by 46
Bergasa, N. V., & Jones, E. A. (1993) · Seminars in Liver Disease · doi:10.1055/s-2007-1007360 · Cited by 36
Bergasa, N. V. (1993) · Hepatology · doi:10.1016/0270-9139(93)92233-p · Cited by 8
Cited by
Sorted by citations
Items 301–343 of 343
Symptomatic Management and Palliation
Lambert, L. (2014) · Medical radiology · doi:10.1007/978-3-642-40558-7_22
Transplantation for Sclerosing Cholangitis
Crippin, J. S. (2005) · Elsevier eBooks · doi:10.1016/b978-0-7216-0118-2.50018-5
Pathophysiological Basis of Pruritus and Fatigue in Cholestasis
Swain, M. G. (2004) · Springer eBooks · doi:10.1007/978-1-4419-9034-1_21
Carey, E. J., Rakela, J. L., & Vargas, H. E. (2014) · Elsevier eBooks · doi:10.1016/b978-1-4557-0268-8.00036-1
NEUROTROPIC AND PSYCHOTROPIC DRUGS IN
Tennyson, H., & Levine, N. S. (2001)
Pruritus in Primary Sclerosing Cholangitis: New Insights into Cause and Treatment
Swain, M. G. (2016) · Springer eBooks · doi:10.1007/978-3-319-40908-5_10
Autoimmune Liver Diseases: Primary Biliary Cholangitis
Ali, A. H., Carey, E. J., & Lindor, K. D. (2016) · Springer eBooks · doi:10.1007/978-3-319-30103-7_16
ORAL NALTREXONE FOR CHOLESTATIC PRURITUS.
Brett, A. (1997) · Journal watch · doi:10.1056/jw199710170000003
James, S. P. (2011) · Wiley eBooks · doi:10.1002/9781119950509.ch21
Transplantation for Sclerosing Cholangitis
Seetharam, A. B., & Crippin, J. S. (2015) · Elsevier eBooks · doi:10.1016/b978-1-4557-0268-8.00014-2
Vandriel, S. M., & Kamath, B. M. (2021) · Springer eBooks · doi:10.1007/978-3-030-80068-0_62
Sherlock, F. S., & BSc, J. D. (2001) · doi:10.1002/9780470986820.ch13
Weißhaar, E., & Yosipovitch, G. (2014) · Wiley eBooks · doi:10.1002/9781118357606.ch71
Brennan, F. P., Dutton, M., & Magann, L. (2018) · Springer eBooks · doi:10.1007/978-3-319-31738-0_18-1
(2022) · Elsevier eBooks · doi:10.1016/b978-3-437-23673-0.00013-6
(2002) · Progress in Palliative Care · doi:10.1080/09699260.2002.11746646
(2015) · Elsevier eBooks · doi:10.1016/b978-3-437-23671-6.00006-7
Kamp, E. J. C. A., Vries, A. C. D., & Bruno, M. J. (2019) · Encyclopedia of Gastroenterology · doi:10.1016/b978-0-12-801238-3.65878-6
(2015) · Elsevier eBooks · doi:10.1016/b978-0-444-53717-1.01129-x
The pruritus of cholestasis: treatment options
Bergasa, N. V. (2007) · Springer eBooks · doi:10.1007/1-4020-2916-0_19
(2018) · Elsevier eBooks · doi:10.1016/b978-3-437-23672-3.00006-8
Arzneimitteltherapiesicherheit und besondere Verfahren
(2015) · Elsevier eBooks · doi:10.1016/b978-3-437-23671-6.00015-8
Yoshida, E. M., & Méndez‐Sánchez, N. (2010) · Annals of Hepatology · doi:10.1016/s1665-2681(19)31649-7
(2018) · Elsevier eBooks · doi:10.1016/b978-3-437-23672-3.00013-5
Brás, S., Amaro, C., & Cardoso, J. (2015) · Journal of the Portuguese Society of Dermatology and Venereology · doi:10.29021/spdv.72.4.315
Opioid Receptor Antagonists or Agonists
Misery, L. (2016) · Springer eBooks · doi:10.1007/978-3-319-33142-3_50
Motility and Other Disorders of the Biliary Tract☆
Adrian, T. E. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.05152-7
Evaluation of the Use of Naltrexone for Cholestatic Pruritus
Sweigart, A. J., Moore, A., Kendsersky, R., Shah, A. A., & Zook, J. (2023) · The Journal of Pediatric Pharmacology and Therapeutics · doi:10.5863/1551-6776-28.6.524
Benign Cutaneous Adverse Reactions to Drugs
Ardern‐Jones, M. R. (2024) · Wiley eBooks · doi:10.1002/9781119709268.rook116
Palliative Management of Skin Symptoms
Brennan, F. P., Dutton, M., & Magann, L. (2024) · Springer eBooks · doi:10.1007/978-3-319-31738-0_18-2
Wakil, A., Koneru, G. K., & Latt, N. L. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-26710-9.00013-4
Palliative Management of Skin Symptoms
Brennan, F. P., Dutton, M., & Magann, L. (2024) · Springer eBooks · doi:10.1007/978-3-031-48991-4_18
von Maltzahn, R., Mayo, M. J., Smith, H. T., Thompson, A. H., Das, S., de Souza, A. R., Lisi, E., Levy, C., McLaughlin, M., & Jones, D. (2024) · Figshare · doi:10.6084/m9.figshare.26732623
Bubna, A. K. (2025) · Springer eBooks · doi:10.1007/978-981-95-3795-2_34
Evaluation and management of primary sclerosing cholangitis patients awaiting liver transplantation
Frolkis, A. D., Nayagam, J. S., Parente, A., Seager, M. J., Sadler, M. D., Montaño‐Loza, A. J., & Joshi, D. (2026) · JHEP Reports · doi:10.1016/j.jhepr.2026.101748
Modulation of mu-opioid pathway for the treatment of pruritus: a systematic review of 1,146 patients
Ahmed, K. M. A., Suleiman, A. A., Alnajdawi, A. I., Abdulkader, D., Ahmed, A. M., Moustafa, A. R. A., & Horton, E. (2026) · Journal of Dermatological Treatment · doi:10.1080/09546634.2026.2646801
General Hepatology Concerns for the Patient with Cholestatic Liver Disease.
Deeb, M., & Ma, M. (2026) · Clinical Liver Disease · doi:10.1016/j.cld.2026.04.007
The Scientific Basis of Cholestatic Liver Disease and Its Symptom Complex
Nguyen, H. H., & Swain, M. G. (2026) · Clinics in Liver Disease · doi:10.1016/j.cld.2026.04.001
Chronic pruritus: modern data on epidemiology, pathogenesis, differential diagnosis and therapy
Savgacheva, M. Y., Skobeleva, T. N., & Ermoshina, M. E. (2026) · Patient-Oriented Medicine and Pharmacy · doi:10.37489/2949-1924-0140
Breckling, M. N., & Streett, M. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-44037-3.00667-9
Systemic pruritus as a neuroimmune disorder: Mechanistic insights and target‐driven therapy
Speeckaert, R., Speeckaert, M. M., Lapeere, H., & Lambert, J. (2026) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.70737
de Azevedo, R. A., Kondo, M., & Oliveira, A. S. B. (2002) · Revista Neurociências · doi:10.34024/rnc.2002.v10.10309
Füsgen, I., & Vogt, H. ‐. (2000) · Springer eBooks · doi:10.1007/978-3-642-59590-5_10
Metadata
- Authors
- Wolfhagen, F., Sternieri, E., Hop, W., Vitale, G., Bertolotti, M., & Van Buuren, H.
- Affiliations
- Erasmus MC (NL)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 1997-10
- Volume
- 113
- Issue
- 4
- Pages
- 1264-1269
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2008756039
- Cited by
- 343
- References
- 10
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 10 · 2023: 12 · 2022: 12 · 2021: 9 · 2020: 7 · 2019: 9 · 2018: 11 · 2017: 9 · 2016: 15 · 2015: 15 · 2014: 14 · 2013: 5 · 2012: 7
- FWCI
- 6.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Keywords
- naltrexone, cholestatic pruritus, chronic cholestasis, antipruritic therapy, opioid antagonists, opioid withdrawal, sleep quality, fatigue, drug tolerability
- MeSH terms
- Administration, Oral, Adult, Aged, Cholestasis, Double-Blind Method, Fatigue, Female, Humans, Liver Cirrhosis, Biliary, Male, Middle Aged, Naltrexone, Narcotic Antagonists, Placebos, Pruritus, Cholangitis, Sclerosing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
