Abstract
Chronic pruritus (CP) is often refractory to conventional therapies leading to a substantial quality of life impairment. Better understanding of the underlying pathophysiological mechanisms allowed the development of novel drugs targeting specific mechanisms, such as neurokinin-1 receptor (NK1R) antagonists. This review aims to provide an overview of the mechanisms of action of NK1R antagonists and the evidence of its efficacy in the treatment of CP of various origins. NK1R and its endogenous ligand substance P mediate itch at peripheral and central levels. Novel NK1R antagonists have shown promising antipruritic properties in open-label studies and case series including patients with CP due to chronic prurigo, cutaneous T cell lymphoma, solid tumors, and biological antitumoral therapies. NK1R antagonists are promising agents in the treatment of CP of different origins. First evidence from randomized controlled trials supports the potency of these agents as a therapeutic option for CP.
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