Abstract
What is this summary about?
This is a summary of an article about people with primary biliary cholangitis (PBC) who also suffer from itch. PBC is a disease that affects the liver; itching is common in PBC and can dramatically reduce a person's quality of life.
People in a study called TARGET-PBC filled in surveys about their PBC symptoms, including itching, and the effects the symptoms had on their lives. Information was also collected on the medications people were taking for their PBC and itch.
What were the results?
Out of 211 people with PBC who filled in the surveys, 170 (81%) had itching. More than one-third of them (37%) had itch that was clinically significant. Clinically significant itch has been defined as an itch that sometimes affects a person's sleep, makes them scratch until their skin is raw, or causes embarrassment. These people would benefit from a discussion about treatment options. Clinically significant itch was linked with worse scores on the surveys, meaning poorer quality of life. This link was true for all areas looked at, but particularly for social aspects and cognition, such as memory and concentration. Sleep was affected in most people with clinically significant itch and there were high levels of fatigue.
People with clinically significant itch were more likely to be taking anti-itch medication compared with those with mild itch, but onethird of them still had not received any treatment for itch. When itch medication was used, the stepwise guidelines suggested by specialty professional societies was not usually followed.
What do the results mean?
Itching is problematic for the people in this study. Those with clinically significant itch have a worse quality of life compared with those with mild itch and this affects all areas of their life measured. The study also shows that people do not always receive medication for their itch, and that treatment guidelines are not always followed.
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Writing disclosure
Medical writing support was provided by Gemma Corr DPhil CMPP, of Fishawack Indicia Ltd, UK, part of Avalere Health, funded by GSK.
Acknowledgments
Target RWE, GSK and the authors would like to thank all the people who took part in this study. A complete list of participating sites and the associated TARGET-PBC investigators can be found in the original article.
Financial & competing interests disclosure
The TARGET-PBC study (registered at clinicaltrials.gov: NCT02932449) is sponsored by Target RWE and the analysis described herein was funded by GSK (GSK study number: 213259). Target RWE, GSK and the authors would like to thank all the people who took part in this study. MJM has research funding from TARGET PharmaSolutions, GSK, Intercept Pharmaceuticals, CymaBay Pharmaceuticals, Genfit, Mirum, and Mallinckrodt; and consultation fees from TARGET PharmaSolutions, GSK, CymaBay Pharmaceuticals, and Mallinckrodt. EC and WRK have no conflicts to report. HTS and MMM are employees of GSK and hold stocks/shares in the company. AT was an employee of GSK at the time of the study and holds stocks/shares in the company. ARM and HLM are Target RWE employees. RAS is a former employee of Target RWE. CLB has research funding from Gilead Biosciences, Intercept Pharmaceuticals, CymaBay Pharmaceuticals, Takeda Pharmaceuticals, GSK, Bristol Myers Squibb, TARGET Pharmasolutions, Novartis, BiomX, Mirum, Genfit, Pliant, Cara Therapeutics, and Boston Scientific. CL has research funding from Escient, Gilead, Intercept, CymaBay, Ipsen, GSK, High Tide, Zydus, Cara Therapeutics, Mirum, Pliant, and Target PharmaSolutions; consultation fees from CymaBay, Ipsen, GSK, Pliant, Mirum, Cara Therapeutics, Calliditas, and Intercept; royalties from UpToDate; and is the Associate Editor for Hepatology journal, Member of the ABIM Test and Policy committee for transplant hepatology. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.