Itching (pruritus) is a highly prevalent symptom that negatively impacts quality of life among patients with chronic liver diseases (CLDs), including primary biliary cholangitis (PBC), according to a study recently published in BMJ Open Gastroenterology.
While some patients experience relatively mild pruritus, others experience severe symptoms. Pruritus is a complication of poor liver function. Despite therapeutic advancements, many patients continue to experience severe pruritic manifestations that are associated with poor overall well-being.
Researchers sought to better understand pruritus as a symptom among patients with CLDs, including PBC. They thus conducted a survey of 307 patients from the United States and Europe with CLDs and itching.
Responses collected indicated that pruritus was associated with a higher disease burden, with a significantly adverse impact on emotional health, the ability to concentrate and intimate relationships.
In describing their pruritus, a high proportion of patients (53.7% to 77.0%) chose to use the phrases “deep itch” and “urgent itch.” The authors noted that “many participants, especially those with PBC and PSC, associated their pruritus with the terms ‘relentless,’ ‘I want to tear my skin off’ and ‘itch until I bleed,’ illustrating the severity of this condition that is generally not relieved by scratching.”
The baseline score for the Worst Itch Numerical Rating Scale (WI-NRS) — which ranges from 0 “no itch” to 10 “worst itch” — was between 3.8 and 5.1. Over a quarter of patients said that their pruritus was more severe since initial onset, while more than 32% characterized their pruritus as being approximately similar in severity since onset.
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Change in pruritus severity did not differ significantly between patients with different CLDs; for example, patients who had “moderate-to-severe” pruritus at baseline continued to report the same after six months.
“In summary, initial findings from this study highlight that pruritus in general (as well as moderate-to-severe pruritus specifically) is common, persistent and can have a profound impact on patients with CLDs over time,” the authors of the study concluded.
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