Efficacy of Treatments for Cholestatic Pruritus: A Systemic Review and Meta-analysis

Cholestatic itch is a disabling symptom that may be secondary to liver or biliary diseases. Management of cholestatic pruritus is complex. A systematic review and meta-analysis on the efficacy of treatments for cholestatic pruritus were performed. PubMed and Cochrane Library were searched using the algorithm (hepatitis OR cholestatic OR liver) AND (pruritus OR itch) AND (management OR treatment OR treatments) for 1975-2019. Of the 2,264 articles identified, 93 were included in a systematic review and 15 in a meta-analysis (studies evaluating pruritus with a visual analogue scale). Some treatments act by reducing levels of pruritogens in the enterohepatic cycle, others modify the metabolism or secretion of these pruritogens, or act on pruritus pathways. A further possible treatment is albumin dialysis. However, due to many heterogeneities in the reviewed studies it is difficult to identify and recommend an optimum treatment. Only 15 studies were included in the meta-analysis, due to the small number of randomized studies using a visual analogue scale.

Automated summary

Cholestatic itch is a debilitating symptom that can be caused by liver or biliary diseases. The management of cholestatic pruritus is complex. A systematic review and meta-analysis were conducted to evaluate the effectiveness of different treatments. The results showed that there are various treatment options available, but due to the heterogeneity of the studies, it is difficult to identify the optimal treatment.