Though it is known to be a common problem, pruritus (itching) is likely underrecognized and undertreated among patients with primary biliary cholangitis (PBC), according to a study recently published in the Annals of Hepatology.
Researchers examined the data of patients with PBC-associated pruritus enrolled in the German PBC registry. Of the 515 patients, 120 (23%) had pruritus, of which 61 (51%) were classified as moderate or severe.
The researchers found that moderate-to-severe pruritus was associated with both depression and psoriasis. Furthermore, patients with pruritus were generally younger at the time of their PBC diagnosis.
Twenty-seven patients received medications with antipruritic effect (i.e., treatment intended to relieve itching). Of these 27 patients, 17 (63%) were prescribed fibrates, making it the most common antipruritic therapy in this cohort of patients. All other antipruritic therapies were used in single cases.
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Researchers reported that the prevalence of pruritus was higher among those who received treatment at a tertiary center (university hospitals) compared with those who received care at a secondary care facility (such as private practices and nonteaching hospitals). Antipruritic medications were more frequently prescribed at tertiary rather than secondary medical centers (26% vs 8%).
Studies continue to show that pruritus is undertreated, with only an estimated one-fifth of all patients receiving treatment. This is despite the availability of a number of medications that can significantly alleviate PBC-associated pruritus.
“Our findings highlight the need for a sophisticated evaluation of the causes of pruritus and for improved systematic management of itch in patients with PBC across all levels of care,” the study’s authors wrote. “Ongoing education on symptoms remains crucial to ensure comprehensive PBC care.”
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