title: Drug treatment of pruritus in liver diseases.
abstract: Pruritus (itch) is a common complication of cholestatic liver diseases (CLD). It can be a distressing and debilitating symptom, causing significant impairment in quality of life. Treatment of pruritus in liver diseases can be challenging and requires specific management with early initiation and a step-wise approach using specific drugs. Clinical trials are ongoing with novel agents that demonstrate potential efficacy. Patients with cholestatic pruritus are likely to present to a variety of clinicians who would benefit from medical awareness of available treatment options. In this review, we outline the pharmaceutical agents currently used to treat cholestatic pruritus and provide the evidence base for targeted symptom control of itch in liver diseases. We also highlight recent developments in the pathophysiology of cholestatic pruritus and the emerging novel therapies.
authors.affiliation: Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK, and Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK vinod.hegade@ncl.ac.uk.
authors.forename: Vinod S
authors.initials: VS
authors.lastname: Hegade
authors.affiliation: Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK, and Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Stuart F W
authors.initials: SF
authors.lastname: Kendrick
authors.affiliation: Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK, and Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: David E J
authors.initials: DE
authors.lastname: Jones
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D065695:Cytochrome P-450 CYP2B6 Inducers / Q000627:therapeutic use*; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D000924:Anticholesteremic Agents; D065695:Cytochrome P-450 CYP2B6 Inducers; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Pruritus; cholestasis; liver disease; primary biliary cirrhosis; treatment