Impact of Pruritus on Quality of Life and Current Treatment Patterns in Patients with Primary Biliary Cholangitis.

Autor: Mayo MJ; University of Texas Southwestern Medical Center, Dallas, TX, USA., Carey E; Mayo Clinic, Phoenix, AZ, USA., Smith HT; GlaxoSmithKline, Brentford, Middlesex, UK., Mospan AR; Target RWE, Durham, NC, USA., McLaughlin M; GlaxoSmithKline, Collegeville, PA, USA., Thompson A; GlaxoSmithKline, RTP, Raleigh, NC, USA., Morris HL; Target RWE, Durham, NC, USA., Sandefur R; Target RWE, Durham, NC, USA., Kim WR; Stanford University, Stanford, CA, USA., Bowlus C; University of California, Davis, Sacramento, CA, USA., Levy C; University of Miami, Miami, FL, USA. CLevy@Med.Miami.edu.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2023 Mar; Vol. 68 (3), pp. 995-1005. Date of Electronic Publication: 2022 Jun 15.
DOI: 10.1007/s10620-022-07581-x
Abstrakt: Background and Aims: Patients with primary biliary cholangitis (PBC) often suffer with pruritus. We describe the impact of pruritus on quality of life and how it is managed in a real-world cohort.
Methods: TARGET-PBC is a longitudinal observational cohort of patients with PBC across the USA. Data include information from medical records for three years prior to the date of consent up to 5 years of follow-up. Enrolled patients were asked to complete patient-reported outcome surveys: PBC-40, 5-D itch, and the PROMIS fatigue survey. Kruskal-Wallis tests were used to compare differences in symptoms between groups.
Results: A total of 211 patients with completed PRO surveys were included in the current study. PRO respondents were compared with non-respondents in the TARGET-PBC population and were broadly similar. Pruritus was reported in 170 patients (81%), with those reporting clinically significant pruritus (30%) scoring worse across each domain of the PBC-40 and 5-D itch, more frequently having cirrhosis, and having significantly greater levels of fatigue. Patients reporting clinically significant pruritus were more likely to receive treatment, but 33% had never received treatment (no itch = 43.9%, mild itch = 38.3%).
Conclusions: The prevalence of pruritus was high in this population, and those reporting clinically significant pruritus had a higher likelihood of having advanced disease and worse quality of life. However, this study found that pruritus in PBC is under-treated. This may be due in part to ineffectiveness of current treatments, poor tolerance, or the lack of FDA-approved medications for pruritus.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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