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Therapeutics for Pruritus in Cholestatic Liver Disease: Many Treatments but Few Cures

  • Autoimmune, Cholestatic, and Biliary Diseases (S Gordon and C Bowlus, Section Editors)
  • Published:
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Abstract

Purpose of Review

Pruritus in cholestatic liver disease is commonly encountered and difficult to eradicate. It has a major impact on quality of life and thus is important to address. This article reviews current and future treatment options for cholestatic pruritus.

Recent Findings

In the last 5 years, the pathogenesis of cholestatic itch has been further clarified via studies of serum autotaxin, which correlates with severity of symptoms and decrease in patients on therapy. New medications under development include apical sodium-dependent bile acid transporters (maralixibat, GSK2330672), fibrates (bezafibrate), and κ-opioid receptor agonists (nalfurafine hydrochloride).

Summary

While many treatments are available to treat this vexing condition, data to support consistent and dramatic improvement with any one medication is lacking. However, with so many options and several new medications under investigation in clinical trials, symptom relief is an achievable goal for many patients.

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  1. Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9151, USA

    Mark Pederson & Marlyn J. Mayo

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Correspondence to Marlyn J. Mayo.

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Mark Pederson declares no conflicts of interest.

Marlyn J. Mayo reports grants from Glaxo Smith Kline, Shire, Intercept, and Pfizer, outside the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Autoimmune, Cholestatic, and Biliary Diseases

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Pederson, M., Mayo, M.J. Therapeutics for Pruritus in Cholestatic Liver Disease: Many Treatments but Few Cures. Curr Hepatology Rep 17, 143–151 (2018). https://doi.org/10.1007/s11901-018-0397-7

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