期刊
EXPERT OPINION ON DRUG SAFETY
卷 20, 期 8, 页码 915-924出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/14740338.2021.1915984
关键词
Pruritus; cholestasis; lysophosphatidic acid; autotaxin; PPAR agonists; IBAT inhibitors; safety
Pruritus is a disabling symptom in cholestatic liver disease, with lysophosphatidic acid (LPA) and autotaxin (ATX) correlating with symptom intensity. Conventional therapies are effective for some patients, but experimental treatments may be necessary for refractory cases. Ongoing research aims to explore new drugs targeting the ATX-LPA axis for a more effective management of cholestatic itching.
Introduction: Pruritus is adisabling symptom common to cholestatic liver disorders. Its pathophysiology has not been completely elucidated and although multiple mediators have been identified, only lysophosphatidic acid (LPA) and its synthetizing enzyme autotaxin (ATX) appear to consistently correlate with symptom intensity. This review aims to summarize the most relevant safety and efficacy data regarding both standard and new medications utilized to treat pruritus in cholestatic liver disease. Areas covered: International societies like the AASLD and EASL recommend astepwise approach for the management of cholestatic itch. However, therapeutic response is variable. Cholestyramine is considered first-line, followed by rifampicin, naltrexone and sertraline. When used appropriately, these medications have afavorable adverse events profile with most side effects related to drug class and not to the underlying etiology of liver disease. Expert opinion: Although conventional therapies seem to be effective in aproportion of patients, asizable number of cases remain refractory and require the utilization of experimental treatments. Multiple potential targets, especially in the ATX-LPA axis have yet to be pharmacologically explored, with ongoing translational and clinical research. Novel drugs are currently being developed for the management of cholestatic itching with promising results and afavorable safety profile.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据