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Meta-Analysis
. 2022 Feb 22:102:adv00653.
doi: 10.2340/actadv.v102.310.

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

Charles Dervout, Nicholas Boulais, Thomas Barnetche, Jean-Baptiste Nousbaum, Emilie Brenaut  1 , Laurent Misery
Affiliations
Meta-Analysis

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

Charles Dervout et al. Acta Derm Venereol. .

Abstract

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.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow chart of the bibliographic search strategy. VAS: visual analogue scale.
Fig. 2
Fig. 2
Results of the meta-analysis. SD: standard deviation; VAS: visual analogue scale; 95% CI: 95% confidence interval.
See this image and copyright information in PMC

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