Although itching has a significant negative effect on the quality of life of people with primary biliary cholangitis (PBC), treatment options to effectively manage it are lacking, according to a recent study published in Liver International.
Almost three-quarters of people with PBC experience itching as a symptom of this liver disease, and more than one-third have moderate-to-severe itching. Doctors suspect that itching is caused by an imbalance in the way the body regulates bile acids, though more research on this is needed.
In this study, researchers surveyed 90 adults with PBC who were divided into two groups: Those with no or mild itching, and those with moderate to severe itching. Surveys revealed that individuals with moderate-to-severe itching had significantly lower quality of life, reporting higher levels of fatigue, concentration problems and impaired social functioning. They experienced greater difficulty with daily activities, higher rates of sleep disturbances and more daytime sleepiness compared to those with mild or no itching. Additionally, fewer people with moderate-to-severe itching were employed (42% vs. 53%).
Despite how severe and disabling the itch was, fewer than 25% of patients with moderate to severe itching were receiving any treatment for it. Those who tried medications like ursodeoxycholic acid, obeticholic acid, antihistamines, bile acid binders or gabapentin often reported little or no relief, and some stopped treatment due to lack of benefit or side effects like drowsiness.
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Many of the patients who took part in this study told the researchers they were frustrated by the lack of options. They expressed their wish for lasting relief that also prevents liver damage, saying that such an improvement would be “fantastic,” “a miracle,” allowing them to “be like a normal person” and “actually sleep.”
“This highlights the significant unmet need for better therapies to manage pruritus in PBC,” the researchers said.
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