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

作者：Marlyn J. Mayo, Elizabeth J. Carey, Helen T. Smith, Andrea R. Mospan, Megan McLaughlin, April Thompson, Heather Morris, Robert Sandefur, W. Ray Kim, Christopher L. Bowlus, the TARGET-PBC Investigators, Victor Ankoma‐Sey, David I. Bernstein, Brian B. Borg, Christopher L. Bowlus, Robert Brown, Elizabeth J. Carey, Virginia Clark, Jama M. Darling, Jonathan A. Dranoff, Hany Elbeshbeshy, Lisa Forman, Aparna Goel, James Hanje, Stephen A. Harrison, Sujit Janardhan, Randhir Jesudoss, David Kim, Lindsay Y. King, Charles Landis, Cynthia Levy, Anna Lok, Michael R. Lucey, V LUKETIC, Richard Manch, W. van der Mark, Marlyn J. Mayo, Edward Mena, Apurva A. Modi, Gautham P. Reddy, K. Rajender Reddy, Fedja A. Rochling, Sergio Rojter, Raymond A. Rubin, Mark Russo, Mitchell Shiffman, Marina G. Silveira, Carmen Stanca, Paul J. Thuluvath, Elizabeth C. Verna, Laurence Weiss, Cynthia Levy · 发表于：Digestive Diseases and Sciences · 年份：2022 · DOI：10.1007/s10620-022-07581-x · 被引用次数：79 · 研究领域：Liver Diseases and Immunity、Dermatology and Skin Diseases、Inflammatory Bowel Disease

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. ...