Efficacy of Treatments for Cholestatic Pruritus: A Systemic Review and Meta-analysis

Cholestatic itch is a disabling symptom that may be secondary to liver or biliary diseases. Management of cholestatic pruritus is complex. A systematic review and meta-analysis on the efficacy of treatments for cholestatic pruritus were performed. PubMed and Cochrane Library were searched using the...

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Bibliographic Details
Published in:Acta dermato-venereologica 2022-02, Vol.102, p.adv00653-adv00653
Main Authors: Dervout, Charles, Boulais, Nicholas, Barnetche, Thomas, Nousbaum, Jean-Baptiste, Brenaut, Emilie, Misery, Laurent
Format: Article
Language:English
Subjects:
acid ursodesoxycholic systematic review
Cholestasis - complications
Cholestasis - diagnosis
Cholestasis - therapy
cholestatic itch
Humans
Original
Pruritus - diagnosis
Pruritus - etiology
Pruritus - therapy
Renal Dialysis
rifampicin
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Summary:Cholestatic itch is a disabling symptom that may be secondary to liver or biliary diseases. Management of cholestatic pruritus is complex. A systematic review and meta-analysis on the efficacy of treatments for cholestatic pruritus were performed. PubMed and Cochrane Library were searched using the algorithm "(hepatitis OR cholestatic OR liver) AND (pruritus OR itch) AND (management OR treatment OR treatments)" for 1975-2019. Of the 2,264 articles identified, 93 were included in a systematic review and 15 in a meta-analysis (studies evaluating pruritus with a visual analogue scale). Some treatments act by reducing levels of pruritogens in the enterohepatic cycle, others modify the metabolism or secretion of these pruritogens, or act on pruritus pathways. A further possible treatment is albumin dialysis. However, due to many heterogeneities in the reviewed studies it is difficult to identify and recommend an optimum treatment. Only 15 studies were included in the meta-analysis, due to the small number of randomized studies using a visual analogue scale.
ISSN:0001-5555
1651-2057
DOI:10.2340/actadv.v102.310