#5584 FIRST EXPERIENCES IN REAL LIFE WITH DIFELIKEFALIN IN GABAPENTIN RESISTANT UREMIC PRURITUS (CKDAP)

Abstract Background and Aims Chronic kidney disease associated pruritus (CKD-aP) has been recognized for over a century. The actual proposed off-label therapeutic option is gabapentin, that showed relevant efficacy in some small trial. Recently difelikefalin (DFK), k-opioid receptor agonist, the first FDA EMA approved drug CKD-aP treatment. We report three treated patients suffering gabapentin- resistant our dialysis center. Method Since March 2022, 2 have with DFK. Before starting treatment every week thereafter until now, completed following scales: Worst-Itch Numerical rating scale (WI-NRS, 0 = no Itch, 10 worst itch), sleep quality (SQS) (from worse to best quality). Results Case 1 (Male, 58 years-old). patient started hemodialysis (HD) 5 years ago. He was gabapentin (WI-NRS 10, SADS C, SQS 3). As soon as DFK available 0.5 mcg/kg/every HD session. There immediate persistent efficacy. After month stopped after 4 months of therapy, WI-NRS absence side effects. 6 but weeks later returned 7, 7). administered again response (Fig. 1a).Case (Female, 81 Two ago she moderate severe gabapentin-resistant CKD-aP. 3. In next we obtained progressive reduction 3 3, 6. At follow up ameliorated significantly (Wi-NRS 9) 1b). 75-years old). suffer initial dementia. year presented scratching lesions on his arms legs complained itching. an period Gabapentin without success Difelikefalin tried. assessment 7 5; apparent benefit scales were particularly fluctuating. also dissociation between improvement persistence high values (after 8). months' follow-up 9 1c). had almost disappeared. Conclusion Our experience seems recognize remarkable drug. particular, complete, lasting response, whereas other able improve very slowly achieved complete at months. suggests partial DFK, date results adopted achieved. conclusion show promising gabapentin. older patiants cognitive problems tools identified measure inadequate.