For US HCPs

For US HCPs

Impact of Cholestatic Pruritus Itch logo

    CHOLESTATIC PRURITUS IS MORE THAN JUST AN ITCH

    Itch is a life sentence of being uncomfortable.

    —A real patient living with cholestatic pruritus in primary biliary cholangitis (PBC)

    HOW DO YOUR PATIENTS WITH PBC DESCRIBE THEIR PRURITUS?

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      ARE YOUR PATIENTS WITH PBC STRUGGLING WITH PRURITUS?

      Biochemical liver tests and stage of liver disease do not consistently correlate with the presence or severity of cholestatic pruritus.2,3

       

      Percentages are approximate, as studies use varying definitions of mild, moderate, and severe pruritus.

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      Up to 81% of patients with PBC experience cholestatic pruritus at some point during the course of their disease4,5*

      Survey icon

      In a survey of 633 patients with PBC, 42% reported itch was not discussed as a key PBC symptom at their most recent doctor’s visit6

      • *

        According to survey results conducted to capture patient-reported experiences of cholestatic pruritus over the course of PBC from 2 separate studies (n/N=1613/2194 and n/N=170/211, respectively).4,5

      If I don't mention my itching, I never get asked about it.

      —A real patient living with cholestatic pruritus

      HOW DOES CHOLESTATIC PRURITUS IMPACT YOUR PATIENTS’ DAILY LIVES?

      SEVERE PRURITUS IS ASSOCIATED WITH FATIGUE AND DEPRESSION3,7

      The severity of symptoms may vary from day to day and person to person, but the impact of pruritus on quality of life can be pervasive, impacting sleep, relationships, and daily activities.2,4

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      58% of patients with PBC and clinically significant itch reported cholestatic pruritus impacted their social lives4†

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      Nearly 3 out of 4 patients with PBC lose sleep due to pruritus1‡

      • †

        Clinically significant itch was defined as ≥7 points from a maximum of 15 on the itch domain of the PBC-40.4

      • ‡

        Itching is often worse at night in patients with PBC and leads to sleep interference in up to 74% of PBC patients with cholestatic pruritus.1

      Itching is like a personal nightmare for me… I’ m up all night, so I don’t get any sleep.

      —A real patient living with cholestatic pruritus

      ENCOURAGE YOUR PATIENTS TO SPEAK UP EARLY AND OFTEN ABOUT THEIR ITCH

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      In a study, 321/2194 patients with PBC felt persistently embarrassed because of their scratching5

      Doctor does not discuss itch icon

      In a survey of 149 patients with cholestatic pruritus, ~70% reported that their doctor does not evaluate itch1

      START A CONVERSATION WITH YOUR PATIENTS AT THEIR NEXT VISIT

      These questions can help:

      1. How often did you experience itching in the last four weeks?
      2. Did it disturb your sleep?
      3. Has the itching affected your home or work life? In what ways?
      Brochure checklist icon

      SCREEN FOR CHOLESTATIC PRURITUS AT EVERY VISIT

      Use this brochure to help have a productive discussion with your patients about the impact of pruritus.

      PATIENT SUPPORT

      These patient advocacy groups provide resources and information to help patients navigate the daily challenges of cholestatic pruritus in PBC.

      PBCers Organization logo

      PBCers ORGANIZATION

      Started in 1995 by Linie Moore, The PBCers Organization’s mission is to offer education and support to PBC patients, family members, and friends, and to raise funds to help research the causes of and cure for PBC.

      PBC Foundation logo

      PBC FOUNDATION

      Supporting people living with PBC in over 80 countries, by providing accurate, up-to-date information on PBC.

      REFERENCES

      1. Rishe E, Azarm A, Bergasa NV. Itch in primary biliary cirrhosis: a patients’ perspective. Acta Derm Venereol. 2008;88(1):34-37. doi:10.2340/00015555-0350
      2. Hegade VS, Bolier R, Oude Elferink RP, Beuers U, Kendrick S, Jones DE. A systematic approach to the management of cholestatic pruritus in primary biliary cirrhosis. Frontline Gastroenterol. 2016;7(3):158-166. doi:10.1136/flgastro-2015-100618
      3. Düll MM, Kremer AE. Evaluation and management of pruritus in primary biliary cholangitis. Clin Liver Dis. 2022;26(4):727-745. doi:10.1016/j.cld.2022.06.009
      4. Mayo MJ, Carey E, Smith HT, et al. Impact of pruritus on quality of life and current treatment patterns in patients with primary biliary cholangitis. Dig Dis Sci. 2023;68(3):995-1005. doi:10.1007/s10620-022-07581-x
      5. Hegade VS, Mells GF, Fisher H, et al. Pruritus is common and undertreated in patients with primary biliary cholangitis in the United Kingdom. Clin Gastroenterol Hepatol. 2019;17(7):1379-1387. doi:10.1016/j.cgh.2018.12.007
      6. Leighton J, Thain C, Mitchell-Thain R, Dyson JK, Jones DE. Patient ownership of primary biliary cholangitis long-term management. Frontline Gastroenterol. 2021;12(5):370-373. doi:10.1136/flgastro-2019-101324
      7. Gungabissoon U, Gibbons DC, Requena G, Ribeiro de Souza A, Smith H. Disease burden of primary biliary cholangitis and associated pruritus based on a cross-sectional US claims analysis. BMJ Open Gastroenterol. 2022;9(1):e000857. doi:10.1136/bmjgast-2021-000857