What treatment options are there for uremic pruritus in an elderly patient with risk of sundowning?

Uremic pruritus is increasingly recognized as a multifactorial condition involving peripheral neuropathy and immune dysregulation, particularly upregulation of type 2 cytokine pathways. Dysregulated opioid signaling further contributes to itch amplification. Accordingly, κ-opioid receptor agonists, ...

Nemolizumab to target the IL-31 pathway has been very beneficial in our patients with secondary pruritus (i.e., neuropathic itch, notalgia paresthetica & bracioradial pruritus, etc), and so far, safely tolerated with the patients I have utilizing treatment. It is challenging to get coverage for off-...