Difelikefalin in pruritus associated with chronic kidney disease: a profile of its use

Abstract

Difelikefalin (Kapruvia®; Korsuva™), a novel peripheral kappa opioid receptor (KOR) agonist, is a promising emerging treatment for moderate-to-severe pruritus associated with chronic kidney disease (CKD) in adults undergoing haemodialysis. Evidence thus far indicates that difelikefalin is effective and generally well tolerated in these patients. In randomized, double-blind, placebo-controlled, multicentre phase 3 trials, difelikefalin produced clinically meaningful improvements in the intensity of itch in patients with moderate-to-severe CKD-associated pruritus. Difelikefalin was also associated with improved itch-related quality of life relative to placebo. Limited data suggest that clinical benefits are maintained over longer-term treatment. The most common treatment-emergent adverse events in difelikefalin recipients are diarrhoea, dizziness and nausea, typically of mild or moderate severity.