Pruritis is commonly associated with primary biliary cholangitis (PBC), and a study presented at the AASLD Liver Meeting indicated that this greatly impacts patients’ quality of life and daily activities.
About 70% of PBC patients experience pruritus that can be severe, with inadequate treatment options to reduce pruritus.
Researchers assessed adults with PBC from a patient advocacy group and a physician panel between December 2023 and March 2024. The study team categorized participants based on the pruritus numerical rating scale (NRS) as no/mild pruritus (NRS <4; n=40) versus moderate/severe pruritus (NRS ≥4; n=50). The mean patient age was 56.7 years in the no/mild group and 52.1 years in the moderate/severe group. Most patients were female (85% and 80%, respectively).
Participants completed the following questionnaires:
- PBC-40;
- Chronic Liver Disease Questionnaire (CLDQ-PBC);
- 5-D itch;
- EQ-5D-5L;
- Functional Assessment of Chronic Illness Therapy – Fatigue Short Form (FACIT-Fatigue); and
- Work Productivity and Activity Impairment (WPAI).
A subset of patients in the moderate/severe group also answered open-ended questions.
Compared with the no/mild pruritus group, the moderate/severe group had statistically significantly worse PBC-40 mean scores in symptom, itch, fatigue, cognitive, and social (P<.05 for all) but not emotional (P=.239) domains. They also had worse scores on FACIT-Fatigue (P<.001) and 5-D itch (P<.001) and lower scores on the CLDQ-PBC (P<.001) and EQ-5D-5L (P=.005).
The moderate/severe group also reported statistically significantly greater activity impairment per the WPAI questionnaire (P<.001). They also had lower work status compared with the no/mild group (42% vs 53%).
Among employed participants, those with moderate/severe pruritus reported more missed work, greater impairment during work, and overall work impairment.
Patients further expressed the “unrelenting, painful nature of itching and its negative impact on emotional/social health and productivity.”
The authors indicated “the need for safe and efficacious PBC treatments that can improve pruritus.”
Reference
Levy C, Younossi Z, Leyoub J, et al. Assessing the health-related quality of life, impairment and productivity among individuals with PBC and pruritus: results from the ITCH-E study. Abstract 4344. Presented at the 2024 American Association for the Study of Liver Diseases’ 75th Liver Meeting; November 15–19, 2024; San Diego.
