Therapeutics for Pruritus in Cholestatic Liver Disease: Many Treatments but Few Cures
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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.
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).
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.
KeywordsItch Primary biliary cholangitis Primary biliary cirrhosis Primary sclerosing cholangitis Bile
Compliance with Ethical Standards
Conflict of Interest
Mark Pederson declares no conflicts of interest.
Marlyn J. Mayo reports grants from Glaxo Smith Kline, Shire, Intercept, and Pfizer, outside the submitted work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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