In patients with chronic liver disease, pruritus is a very common symptom. But the frequency and severity of pruritus in patients with chronic liver disease is still unclear. A large cohort investigated the frequency, severity and predictive factors of pruritus in chronic liver disease patients.

A total of 2477 patients with chronic liver disease without allergies or skin diseases were examined for itch frequency and severity. Itch severity was self-assessed using pruritus scores and the numerical rating scale (NRS). Multivariate regression analysis was performed to recognize factors associated with pruritus. Serum autotaxin levels were also measured in patients with primary biliary cholangitis (PBC), and the association to liver fibrosis and pruritus was analyzed.

The occurrence of pruritus in patients with chronic liver disease was suggestively greater than in participants without liver disease (29.8 and 16.2%, respectively, P < 0.001). NRS was on the higher side in patients with chronic liver disease, especially in PBC. Multivariate investigation identified lower albumin, higher eosinophil count, and etiology of PBC as independent factors related with severe pruritus (≥5 points of NRS). In PBC patients, serum autotaxin levels were correlated with liver fibrosis markers and hepatobiliary enzymes. No significant links were found between serum autotaxin levels and occurrence and severity of pruritus were seen in patients with PBC.

The study concluded that the frequency of pruritus was increased in patients with chronic liver disease. Based on the large number of patients with chronic liver disease, reduction of liver function is associated with severe pruritus.

Source: Fujino H, Tanaka M, Imamura M, et al. Pruritus in patients with chronic liver disease and serum autotaxin levels in patients with primary biliary cholangitis. BMC Gastroenterol. 2019;19(1):169. Published 2019 Oct 24.