Pruritus in primary biliary cholangitis: insights from the German PBC registry across secondary and tertiary care.
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Herta Toni, Franke Annegret, Müller Tobias, Stein Kerstin, Bantel Heike, Günther Rainer, Denk Gerald, Reuken Philipp A, Schattenberg Jörn M, Naumann Uwe, Böttler Tobias, Weber Andreas, Zeuzem Stefan, Hinz Matthias, Greinert Robin, Berg Christoph, Wissniowski Thaddäus Till, Simon Karl-Georg, Trebicka Jonel, Behrens Rüdiger, Grümmer Harald, Hofmann Wolf Peter, Dikopoulos Nektarios, Sarrazin Christoph, Roeb Elke, Muche Marion, Ringelhan Marc, Teufel Andreas, Merle Uta, Keitel Verena, Marquardt Jens U, Kautz Achim, Tacke Frank, Piotrowski Katja, Köppe-Bauernfeind Nicole, Trautwein Christian, Berg Thomas, Wiegand Johannes, Kremer Andreas E
Аннотация
PATIENTS AND METHODS: Within the German PBC registry, the intensity and management of pruritus were assessed cross-sectionally by treating physicians using a standardized 4-point verbal rating scale (absent, mild, moderate, severe), as well as by analyzing prescribed antipruritic medications.
RESULTS: Pruritus was reported in 23 % (n = 120/515) of patients and classified as mild, moderate, or severe in 59 (49 %), 41 (34 %), and 20 (17 %) cases, respectively. The prevalence of pruritus was 27 % (n = 96/360) for tertiary versus 16 % (n = 24/155) for secondary care (p = 0.006). Moderate or severe pruritus was observed in 13.3 % (n = 48/360) of patients at tertiary centers compared to 8.4 % (n = 13/155) at secondary centers (p = 0.137). Antipruritic therapies were used in only 22.5 % (n = 27/120) patients with pruritus, with bezafibrate being the most frequently prescribed medication (63 %, n = 17/27). Patients with pruritus were more likely to receive antipruritic therapies in tertiary than secondary care: 26 % (n = 25/96) vs. 8 % (n = 2/24) (p = 0.098).
CONCLUSIONS: Pruritus in patients with PBC is common and under-treated in the real-world scenario. Assessment and management vary by healthcare level, highlighting the need for standardized care and greater awareness of treatment options across all settings.