Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panel
Background and aimsThis article provides expert guidance on the management of pruritus symptoms in patients receiving obeticholic acid (OCA) as treatment for primary biliary cholangitis (PBC). PBC is a chronic, autoimmune cholestatic liver disease that affects intrahepatic bile ducts. If not adequat...
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doaj-e72f88a6fde64c119109678fa6898a942020-11-25T02:24:32ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742019-06-016110.1136/bmjgast-2018-000256Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panelJennifer PateJuilo A GutierrezCatherine T FrenetteAparna GoelSonal KumarRichard A ManchEdward A MenaPaul J PockrosSanjaya K SatapathyKidist K YimamRobert G GishBackground and aimsThis article provides expert guidance on the management of pruritus symptoms in patients receiving obeticholic acid (OCA) as treatment for primary biliary cholangitis (PBC). PBC is a chronic, autoimmune cholestatic liver disease that affects intrahepatic bile ducts. If not adequately treated, PBC can lead to cholestasis and end-stage liver disease, which may require transplant. Timely treatment is therefore vital to patient health. Pruritus is a common symptom in patients with PBC. Additionally, the use of OCA to treat PBC can contribute to increased pruritus severity in some patients, adding to patient discomfort, decreasing patient quality of life (QoL), and potentially affecting patient adherence to OCA treatment.MethodsIn May 2018, a group of physician experts from the fields of gastroenterology, hepatology, and psychiatry met to discuss the management of pruritus in OCA-treated patients with PBC. Recognizing the importance of optimizing treatment for PBC, these experts developed recommendations for managing pruritus symptoms in the OCA-treated PBC patient based on their experience in clinical practice.ResultsThese recommendations include a comprehensive list of management strategies (including over-the-counter, prescription, and alternative therapies), guidance on titration of OCA to minimize pruritus severity, and an algorithm that outlines a practical approach to follow up with patients receiving OCA, to better assess and manage pruritus symptoms.ConclusionsPruritus associated with OCA therapy is dose dependent and often manageable, and with the proper education and tools, most pruritus cases can be effectively managed to minimize treatment discontinuation. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jennifer Pate Juilo A Gutierrez Catherine T Frenette Aparna Goel Sonal Kumar Richard A Manch Edward A Mena Paul J Pockros Sanjaya K Satapathy Kidist K Yimam Robert G Gish |
spellingShingle |
Jennifer Pate Juilo A Gutierrez Catherine T Frenette Aparna Goel Sonal Kumar Richard A Manch Edward A Mena Paul J Pockros Sanjaya K Satapathy Kidist K Yimam Robert G Gish Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panel BMJ Open Gastroenterology |
author_facet |
Jennifer Pate Juilo A Gutierrez Catherine T Frenette Aparna Goel Sonal Kumar Richard A Manch Edward A Mena Paul J Pockros Sanjaya K Satapathy Kidist K Yimam Robert G Gish |
author_sort |
Jennifer Pate |
title |
Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panel |
title_short |
Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panel |
title_full |
Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panel |
title_fullStr |
Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panel |
title_full_unstemmed |
Practical strategies for pruritus management in the obeticholic acid-treated patient with PBC: proceedings from the 2018 expert panel |
title_sort |
practical strategies for pruritus management in the obeticholic acid-treated patient with pbc: proceedings from the 2018 expert panel |
publisher |
BMJ Publishing Group |
series |
BMJ Open Gastroenterology |
issn |
2054-4774 |
publishDate |
2019-06-01 |
description |
Background and aimsThis article provides expert guidance on the management of pruritus symptoms in patients receiving obeticholic acid (OCA) as treatment for primary biliary cholangitis (PBC). PBC is a chronic, autoimmune cholestatic liver disease that affects intrahepatic bile ducts. If not adequately treated, PBC can lead to cholestasis and end-stage liver disease, which may require transplant. Timely treatment is therefore vital to patient health. Pruritus is a common symptom in patients with PBC. Additionally, the use of OCA to treat PBC can contribute to increased pruritus severity in some patients, adding to patient discomfort, decreasing patient quality of life (QoL), and potentially affecting patient adherence to OCA treatment.MethodsIn May 2018, a group of physician experts from the fields of gastroenterology, hepatology, and psychiatry met to discuss the management of pruritus in OCA-treated patients with PBC. Recognizing the importance of optimizing treatment for PBC, these experts developed recommendations for managing pruritus symptoms in the OCA-treated PBC patient based on their experience in clinical practice.ResultsThese recommendations include a comprehensive list of management strategies (including over-the-counter, prescription, and alternative therapies), guidance on titration of OCA to minimize pruritus severity, and an algorithm that outlines a practical approach to follow up with patients receiving OCA, to better assess and manage pruritus symptoms.ConclusionsPruritus associated with OCA therapy is dose dependent and often manageable, and with the proper education and tools, most pruritus cases can be effectively managed to minimize treatment discontinuation. |
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