中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 4
Apr.  2021
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Article Contents

Management of pruritus in primary biliary cholangitis

DOI: 10.3969/j.issn.1001-5256.2021.04.049
  • Received Date: 2020-09-22
  • Accepted Date: 2020-10-19
  • Published Date: 2021-04-20
  • Primary biliary cholangitis (PBC) is a progressive intrahepatic cholestatic autoimmune disease, and pruritus can be seen in 60%-70% of PBC patients and seriously affects patients' quality of life. Improving the symptoms of pruritus in PBC patients is of great significance for improving their quality of life. This article mainly summarizes the advances in the pathogenesis of PBC and the treatment of PBC-related pruritus.

     

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  • [1]
    PRINCE M, CHETWYND A, NEWMAN W, et al. Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: Follow-up for up to 28 years[J]. Gastroenterology, 2002, 123(4): 1044-1051. DOI: 10.1053/gast.2002.36027.
    [2]
    QUARNETI C, MURATORI P, LALANNE C, et al. Fatigue and pruritus at onset identify a more aggressive subset of primary biliary cirrhosis[J]. Liver Int, 2015, 35(2): 636-641. DOI: 10.1111/liv.12560.
    [3]
    LANZINI A, de TAVONATTI MG, PANAROTTO B, et al. Intestinal absorption of the bile acid analogue 75Se-homocholic acid-taurine is increased in primary biliary cirrhosis, and reverts to normal during ursodeoxycholic acid administration[J]. Gut, 2003, 52(9): 1371-1375. DOI: 10.1136/gut.52.9.1371.
    [4]
    BEUERS U, KREMER AE, BOLIER R, et al. Pruritus in cholestasis: Facts and fiction[J]. Hepatology, 2014, 60(1): 399-407. DOI: 10.1002/hep.26909.
    [5]
    HEGADE VS, BOLIER R, OUDE ELFERINK RP, et al. A systematic approach to the management of cholestatic pruritus in primary biliary cirrhosis[J]. Frontline Gastroenterol, 2016, 7(3): 158-166. DOI: 10.1136/flgastro-2015-100618.
    [6]
    TAJIRI K, SHIMIZU Y. Recent advances in the management of pruritus in chronic liver diseases[J]. World J Gastroenterol, 2017, 23(19): 3418-3426. DOI: 10.3748/wjg.v23.i19.3418.
    [7]
    LIU XY, LIU ZC, SUN YG, et al. Unidirectional cross-activation of GRPR by MOR1D uncouples itch and analgesia induced by opioids[J]. Cell, 2011, 147(2): 447-458. DOI: 10.1016/j.cell.2011.08.043.
    [8]
    GRAND'MAISON S, DURAND M, MAHONE M. The effects of ursodeoxycholic acid treatment for intrahepatic cholestasis of pregnancy on maternal and fetal outcomes: A meta-analysis including non-randomized studies[J]. J Obstet Gynaecol Can, 2014, 36(7): 632-641. DOI: 10.1016/S1701-2163(15)30544-2.
    [9]
    European Association for the Study of the Liver. EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis[J]. J Hepatol, 2017, 67(1): 145-172. DOI: 10.1016/j.jhep.2017.03.022.
    [10]
    BERGASA NV. The pruritus of cholestasis[J]. J Hepatol, 2005, 43(6): 1078-1088. DOI: 10.1016/j.jhep.2005.09.004.
    [11]
    DATTA DV, SHERLOCK S. Treatment of pruritus of obstructive jaundice with cholestyramine[J]. Br Med J, 1963, 1(5325): 216-219. DOI: 10.1136/bmj.1.5325.216.
    [12]
    KUIPER EM, van ERPECUM KJ, BEUERS U, et al. The potent bile acid sequestrant colesevelam is not effective in cholestatic pruritus: Results of a double-blind, randomized, placebo-controlled trial[J]. Hepatology, 2010, 52(4): 1334-1340. DOI: 10.1002/hep.23821.
    [13]
    GHENT CN, CARRUTHERS SG. Treatment of pruritus in primary biliary cirrhosis with rifampin. Results of a double-blind, crossover, randomized trial[J]. Gastroenterology, 1988, 94(2): 488-493. http://gut.bmj.com/external-ref?access_num=3275568&link_type=MED
    [14]
    PODESTA A, LOPEZ P, TERG R, et al. Treatment of pruritus of primary biliary cirrhosis with rifampin[J]. Dig Dis Sci, 1991, 36(2): 216-220. DOI: 10.1007/BF01300759.
    [15]
    TANDON P, ROWE BH, van der MEER B, et al. The efficacy and safety of bile acid binding agents, opioid antagonists, or rifampin in the treatment of cholestasis-associated pruritus[J]. Am J Gastroenterol, 2007, 102(7): 1528-1536. DOI: 10.1111/j.1572-0241.2007.01200.x.
    [16]
    KHURANA S, SINGH P. Rifampin is safe for treatment of pruritus due to chronic cholestasis: A meta-analysis of prospective randomized-controlled trials[J]. Liver Int, 2006, 26(8): 943-948. DOI: 10.1111/j.1478-3231.2006.01326.x.
    [17]
    SHAH RA, KOWDLEY KV. Mechanisms and treatments of pruritus in primary biliary cholangitis[J]. Semin Liver Dis, 2019, 39(2): 209-220. DOI: 10.1055/s-0039-1679918.
    [18]
    PONGCHAROEN P, FLEISCHER AB Jr. An evidence-based review of systemic treatments for itch[J]. Eur J Pain, 2016, 20(1): 24-31. DOI: 10.1002/ejp.766.
    [19]
    WOLFHAGEN FH, STERNIERI E, HOP WC, et al. Oral naltrexone treatment for cholestatic pruritus: A double-blind, placebo-controlled study[J]. Gastroenterology, 1997, 113(4): 1264-1269. DOI: 10.1053/gast.1997.v113.pm9322521.
    [20]
    TERG R, CORONEL E, SORDÁ J, et al. Efficacy and safety of oral naltrexone treatment for pruritus of cholestasis, a crossover, double blind, placebo-controlled study[J]. J Hepatol, 2002, 37(6): 717-722. DOI: 10.1016/s0168-8278(02)00318-5.
    [21]
    European Association for the Study of the Liver. EASL clinical practice guidelines: Management of cholestatic liver diseases[J]. J Hepatol, 2009, 51(2): 237-267. DOI: 10.1016/j.jhep.2009.04.009.
    [22]
    MCRAE CA, PRINCE MI, HUDSON M, et al. Pain as a complication of use of opiate antagonists for symptom control in cholestasis[J]. Gastroenterology, 2003, 125(2): 591-596. DOI: 10.1016/s0016-5085(03)00879-5.
    [23]
    BROWNING J, COMBES B, MAYO MJ. Long-term efficacy of sertraline as a treatment for cholestatic pruritus in patients with primary biliary cirrhosis[J]. Am J Gastroenterol, 2003, 98(12): 2736-2741. DOI: 10.1111/j.1572-0241.2003.08662.x.
    [24]
    MAYO MJ, HANDEM I, SALDANA S, et al. Sertraline as a first-line treatment for cholestatic pruritus[J]. Hepatology, 2007, 45(3): 666-674. DOI: 10.1002/hep.21553.
    [25]
    JONES EA, MOLENAAR HA, OOSTING J. Ondansetron and pruritus in chronic liver disease: A controlled study[J]. Hepatogastroenterology, 2007, 54(76): 1196-1199. http://www.ncbi.nlm.nih.gov/pubmed/17629069
    [26]
    BARRY DM, MUNANAIRI A, CHEN ZF. Spinal mechanisms of itch transmission[J]. Neurosci Bull, 2018, 34(1): 156-164. DOI: 10.1007/s12264-017-0125-2.
    [27]
    KREMER AE, MARTENS JJ, KULIK W, et al. Lysophosphatidic acid is a potential mediator of cholestatic pruritus[J]. Gastroenterology, 2010, 139(3): 1008-1018. DOI: 10.1053/j.gastro.2010.05.009.
    [28]
    HEGADE VS, KRAWCZYK M, KREMER AE, et al. The safety and efficacy of nasobiliary drainage in the treatment of refractory cholestatic pruritus: A multicentre European study[J]. Aliment Pharmacol Ther, 2016, 43(2): 294-302. DOI: 10.1111/apt.13449.
    [29]
    KRAWCZYK M, LIEBE R, WASILEWICZ M, et al. Plasmapheresis exerts a long-lasting antipruritic effect in severe cholestatic itch[J]. Liver Int, 2017, 37(5): 743-747. DOI: 10.1111/liv.13281.
    [30]
    PARÉS A, HERRERA M, AVILÉS J, et al. Treatment of resistant pruritus from cholestasis with albumin dialysis: Combined analysis of patients from three centers[J]. J Hepatol, 2010, 53(2): 307-312. DOI: 10.1016/j.jhep.2010.02.031.
    [31]
    KHUNGAR V, GOLDBERG DS. Liver transplantation for cholestatic liver diseases in adults[J]. Clin Liver Dis, 2016, 20(1): 191-203. DOI: 10.1016/j.cld.2015.08.011.
    [32]
    REIG A, SESÉ P, PARÉS A. Effects of bezafibrate on outcome and pruritus in primary biliary cholangitis with suboptimal ursodeoxycholic acid response[J]. Am J Gastroenterol, 2018, 113(1): 49-55. DOI: 10.1038/ajg.2017.287.
    [33]
    CORPECHOT C, CHAZOUILLÈRES O, ROUSSEAU A, et al. A placebo-controlled trial of bezafibrate in primary biliary cholangitis[J]. N Engl J Med, 2018, 378(23): 2171-2181. DOI: 10.1056/NEJMoa1714519.
    [34]
    LINDOR KD, BOWLUS CL, BOYER J, et al. Primary biliary cholangitis: 2018 practice guidance from the American Association for the study of liver diseases[J]. Hepatology, 2019, 69(1): 394-419. DOI: 10.1002/hep.30145.
    [35]
    HEGADE VS, KENDRICK SF, DOBBINS RL, et al. BAT117213: Ileal bile acid transporter (IBAT) inhibition as a treatment for pruritus in primary biliary cirrhosis: Study protocol for a randomised controlled trial[J]. BMC Gastroenterol, 2016, 16(1): 71. DOI: 10.1186/s12876-016-0481-9.
    [36]
    MAYO MJ, POCKROS PJ, JONES D, et al. A randomized, controlled, phase 2 study of Maralixibat in the treatment of itching associated with primary biliary cholangitis[J]. Hepatol Commun, 2019, 3(3): 365-381. DOI: 10.1002/hep4.1305.
    [37]
    HEGADE VS, KENDRICK SF, DOBBINS RL, et al. Effect of ileal bile acid transporter inhibitor GSK2330672 on pruritus in primary biliary cholangitis: A double-blind, randomised, placebo-controlled, crossover, phase 2a study[J]. Lancet, 2017, 389(10074): 1114-1123. DOI: 10.1016/S0140-6736(17)30319-7.
    [38]
    KUMADA H, MIYAKAWA H, MURAMATSU T, et al. Efficacy of nalfurafine hydrochloride in patients with chronic liver disease with refractory pruritus: A randomized, double-blind trial[J]. Hepatol Res, 2017, 47(10): 972-982. DOI: 10.1111/hepr.12830.
    [39]
    KAMIMURA K, YOKOO T, KAMIMURA H, et al. Long-term efficacy and safety of nalfurafine hydrochloride on pruritus in chronic liver disease patients: Patient-reported outcome based analyses[J]. PLoS One, 2017, 12(6): e0178991. DOI: 10.1371/journal.pone.0178991.
    [40]
    DECOCK S, ROELANDTS R, STEENBERGEN WV, et al. Cholestasis-induced pruritus treated with ultraviolet B phototherapy: An observational case series study[J]. J Hepatol, 2012, 57(3): 637-641. DOI: 10.1016/j.jhep.2012.04.023.
    [41]
    MAIONE S, COSTA B, di MARZO V. Endocannabinoids: A unique opportunity to develop multitarget analgesics[J]. Pain, 2013, 154(Suppl 1): s87-s93. DOI: 10.1016/j.pain.2013.03.023.
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