{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T06:25:58Z","timestamp":1778135158103,"version":"3.51.4"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":6393,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1998,3]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>The aims of this study were to determine whether long-term oral administration of the opiate antagonist nalmefene is associated with any beneficial effects in patients with pruritus secondary to cholestatic liver disease and to assess the safety of long-term administration of this drug to these patients. Fourteen patients with unrelieved chronic pruritus of cholestasis were studied. Scratching activity, independent of limb movements, was recorded continuously for 24-hour periods before and during treatment with an initial ameliorating dose of nalmefene. Simultaneously, during these periods, visual analogue scores (VASs) of pruritus were recorded every 4 hours while patients were awake. The dose of nalmefene, which initially was 2 mg orally twice daily, was increased during the study, usually until a satisfactory clinical response was achieved. Five patients experienced a transient opioid withdrawal-like reaction that did not preclude continuing with nalmefene therapy. Serum biochemical indices of cholestasis did not change appreciably during treatment. Thirteen patients reported amelioration of the perception of pruritus on nalmefene. In 5 patients, exacerbations of pruritus occurred approximately 4 weeks after an initial ameliorating dose had been reached; these exacerbations were managed by increasing the dose. Baseline mean values for VAS and scratching activity were higher than corresponding means during nalmefene therapy in 13 (<jats:italic toggle=\"yes\">P<\/jats:italic> =.002) and 12 (<jats:italic toggle=\"yes\">P<\/jats:italic> = .013) patients, respectively. Possible tolerance to nalmefene occurred in 3 patients. Three patients experienced marked exacerbation of pruritus after nalmefene therapy was suddenly discontinued. Blood levels of nalmefene were consistent with normal pharmacokinetics of the drug. These results suggest that nalmefene may have a favorable risk-to-benefit ratio when it is administered orally long-term to patients with the pruritus of cholestasis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510270307","type":"journal-article","created":{"date-parts":[[2004,7,27]],"date-time":"2004-07-27T23:44:28Z","timestamp":1090971868000},"page":"679-684","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":148,"title":["Open-label trial of oral nalmefene therapy for the pruritus of cholestasis\u2020"],"prefix":"10.1097","volume":"27","author":[{"given":"Nora V.","family":"Bergasa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas L.","family":"Talbot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Alling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark G.","family":"Swain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria L.","family":"Turner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice B.","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony E.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"BIB1","first-page":"224","volume":"27","author":"Elias","year":"1993","journal-title":"J R Coll Physicians Lond"},{"key":"BIB2","first-page":"1404","volume":"86","author":"Bergasa","year":"1991","journal-title":"Am J Gastroenterol"},{"key":"BIB3","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1016\/0016-5085(95)90709-2","volume":"108","author":"Bergasa","year":"1995","journal-title":"Gastroenterology"},{"key":"BIB4","doi-asserted-by":"crossref","first-page":"3359","DOI":"10.1001\/jama.1992.03490230089034","volume":"268","author":"Jones","year":"1992","journal-title":"JAMA"},{"key":"BIB5","first-page":"491","volume-title":"The pharmacologic basis of therapeutics","author":"Jaffe","year":"1985","unstructured":"Opioid analgesics and antagonists. In: eds. The pharmacologic basis of therapeutics. 7 New York: Macmillan, 1985;491-531."},{"key":"BIB6","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1001\/archderm.1948.01520180045006","volume":"57","author":"Koenigstein","year":"1948","journal-title":"Arch Dermatol Syph"},{"key":"BIB7","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0006-8993(92)91227-6","volume":"585","author":"Thomas","year":"1992","journal-title":"Brain Res"},{"key":"BIB8","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1136\/bmj.297.6662.1501","volume":"297","author":"Thornton","year":"1988","journal-title":"Br Med J"},{"key":"BIB9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0168-8278(05)80471-4","volume":"20","author":"Bergasa","year":"1994","journal-title":"J Hepatol"},{"key":"BIB10","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1001\/archderm.1979.04010110058029","volume":"115","author":"Bernstein","year":"1979","journal-title":"Arch Dermatol"},{"key":"BIB11","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/0016-5085(92)90102-5","volume":"102","author":"Bergasa","year":"1992","journal-title":"Gastroenterology"},{"key":"BIB12","doi-asserted-by":"crossref","first-page":"161","DOI":"10.7326\/0003-4819-123-3-199508010-00001","volume":"123","author":"Bergasa","year":"1995","journal-title":"Ann Intern Med"},{"key":"BIB13","first-page":"1642","volume-title":"Avery's Drug Treatment","author":"Speight","year":"1997","unstructured":"In: eds. Avery's Drug Treatment. Ed. 4. Auckland: Adis International, 1997;1642."},{"key":"BIB14","first-page":"400","volume":"25","author":"Talbot","year":"1991","journal-title":"Biomed Instrument Technol"},{"key":"BIB15","first-page":"449","volume":"42","author":"Hsiao","year":"1983","journal-title":"Res Commun Chem Pathol Pharmacol"},{"key":"BIB16","first-page":"13","volume-title":"The pharmacokinetic process. Oxford textbook of clinical pharmacology and drug therapy","author":"Grahame-Smith","year":"1992","unstructured":"The pharmacokinetic process. Oxford textbook of clinical pharmacology and drug therapy. 2nd Ed. Oxford: Oxford University. 1992;13-39."},{"key":"BIB17","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1056\/NEJM197205042861808","volume":"286","author":"Dole","year":"1972","journal-title":"N Engl J Med"},{"key":"BIB18","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1038\/clpt.1986.220","volume":"40","author":"Gal","year":"1986","journal-title":"Clin Pharm Ther"},{"key":"BIB19","first-page":"175","volume":"7","author":"Michel","year":"1985","journal-title":"Methods Find Exp Clin Pharmacol"},{"key":"BIB20","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1038\/clpt.1986.9","volume":"39","author":"Dixon","year":"1986","journal-title":"Clin Pharmacol Ther"},{"key":"BIB21","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1126\/science.6250222","volume":"209","author":"Morley","year":"1980","journal-title":"Science"},{"key":"BIB22","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1053\/gast.1997.v113.pm9322521","volume":"113","author":"Wolfhagen","year":"1997","journal-title":"Gastroenterology"},{"key":"BIB23","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/S0140-6736(86)91196-7","volume":"1","author":"Mitchell","year":"1986","journal-title":"Lancet"},{"key":"BIB24","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/0168-8278(92)90040-V","volume":"15","author":"Bergasa","year":"1992","journal-title":"J Hepatol"},{"key":"BIB25","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0006-8993(82)90811-3","volume":"245","author":"Zukin","year":"1982","journal-title":"Brain Res"},{"key":"BIB26","first-page":"439","volume":"232","author":"Tempel","year":"1985","journal-title":"J Pharmacol Exp Ther"},{"key":"BIB27","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/0014-2999(78)90343-6","volume":"51","author":"Lahti","year":"1978","journal-title":"Eur J Pharmacol"},{"key":"BIB28","first-page":"809","volume":"240","author":"Tao","year":"1987","journal-title":"J Pharmacol Exp Ther"},{"key":"BIB29","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/978-1-60761-990-1_12","volume-title":"Regulation of opioid receptors. The opiate receptor","author":"Blanchard","year":"1988","unstructured":"Regulation of opioid receptors. The opiate receptor. ed. Clifton, NJ: Humana Press. 1988;425-439."}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.510270307","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-199803000-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T00:08:39Z","timestamp":1731715719000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-199803000-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,3]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1998]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.510270307","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[1998,3]]}}}