原发性硬化性胆管炎瘙痒的治疗:自身免疫性肝病登记联盟分析。

IF 5.6 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatology Communications Pub Date : 2025-05-06 eCollection Date: 2025-05-01 DOI:10.1097/HC9.0000000000000703
Richard Dean, Maryam Yazdanfar, Joseph Zepeda, Cynthia Levy, Craig Lammert, Daniel Pratt, Stuart C Gordon, Lisa Forman, David N Assis, Ashleigh McGirr, Megan McLaughlin, Sumanta Mukherjee, Usha Gungabissoon, Christopher L Bowlus
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引用次数: 0

摘要

背景:原发性硬化性胆管炎(PSC)引起的胆汁淤积常引起瘙痒。然而,瘙痒症的患病率及其管理尚未得到很好的研究。调查原发性硬化性胆管炎(瘙痒- psc)的胆汁淤积性瘙痒包括回顾性医疗记录审查,以确定瘙痒的患病率,严重程度和治疗模式。方法:收集美国5个学术医疗中心的数据。在医疗记录中搜索“瘙痒”和“瘙痒症”,并提取与瘙痒严重程度、接触次数和治疗相关的数据。结果:724例PSC患者中,359例(50%)患者有瘙痒史,其中轻度、中度和重度瘙痒分别占40%、39%和21%。与大导管PSC相比,小导管PSC患者瘙痒较少(p=0.02),西班牙裔比非西班牙裔更常见(p=0.001)。与轻度瘙痒患者相比,中度或重度瘙痒患者更年轻,肝脏生化水平更高,更频繁地接触瘙痒,更频繁地服用2种或更多种止痒药物。胆汁酸结合树脂占36%,羟嗪占23%,利福平占11%,非诺贝特占4%。瘙痒的患病率和严重程度不受肝硬化、肝功能失代偿或炎症性肠病的影响。结论:瘙痒在PSC患者中很常见,通常与多次使用止痒药有关。PSC患者瘙痒的有效治疗仍然是一个未满足的需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of pruritus in primary sclerosing cholangitis: Analysis of the consortium for autoimmune liver disease registry.

Background: Cholestasis from primary sclerosing cholangitis (PSC) frequently causes pruritus. However, the prevalence of pruritus and its management have not been well studied. Investigating the Cholestatic Pruritus of Primary Sclerosing Cholangitis (ItCh-PSC) includes a retrospective medical record review to determine the prevalence, severity, and treatment patterns of pruritus.

Methods: Data was collected at 5 academic medical centers in the United States. Medical records were searched for the terms "itch" and "pruritus" and data abstracted related to itch severity, number of encounters, and treatment.

Results: Among 724 patients with PSC, 359 (50%) of patients had a documented history of pruritus, including 40%, 39%, and 21% with mild, moderate, or severe itch. Itch was less common in those with small ducts compared to large duct PSC (p=0.02) and more frequent in those of Hispanic versus non-Hispanic ethnicity (p=0.001). Compared to patients with mild itch, patients with moderate or severe itch were younger, and had more elevated liver biochemistries, more encounters with itch, and more frequently prescribed 2 or more anti-pruritic medications. Bile acid-binding resins were prescribed in 36%, hydroxyzine in 23%, rifampin in 11%, and fenofibrate in 4% of patients with any itch. The prevalence and severity of pruritus were not affected by cirrhosis, hepatic decompensation, or inflammatory bowel disease.

Conclusion: Itch is common in patients with PSC and is often associated with multiple prescriptions of antipruritic agents. Effective treatments for pruritus in patients with PSC remain an unmet need.

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来源期刊
Hepatology Communications
Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
8.00
自引率
2.00%
发文量
248
审稿时长
8 weeks
期刊介绍: Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction. ​
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