Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2017; 23(19): 3418-3426
Published online May 21, 2017. doi: 10.3748/wjg.v23.i19.3418
Recent advances in the management of pruritus in chronic liver diseases
Kazuto Tajiri, Yukihiro Shimizu
Kazuto Tajiri, Department of Gastroenterology, Toyama University Hospital, Toyama 939-1724, Japan
Yukihiro Shimizu, Gastroenterology Center, Nanto Municipal Hospital, Toyama 939-1724, Japan
Author contributions: Tajiri K and Shimizu Y wrote this paper, Tajiri K conducted this work.
Conflict-of-interest statement: Tajiri K and Shimizu Y declare no conflict of interests for this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Kazuto Tajiri, MD, PhD, Department of Gastroenterology, Toyama University Hospital, 2630 Sugitani, Toyama 939-1724, Japan.
Telephone: +81-76-4347301 Fax: +81-76-4345027
Received: January 23, 2017
Peer-review started: January 28, 2017
First decision: March 3, 2017
Revised: March 13, 2017
Accepted: May 4, 2017
Article in press: May 4, 2017
Published online: May 21, 2017

Pruritus is a symptom found in patients with chronic liver diseases, especially cholestatic liver diseases such as primary biliary cholangitis. This symptom impairs patient quality of life by disturbing sleep and may lead to consideration of liver transplantation. Mechanisms implicated in pruritus have been associated with the peripheral and central nervous systems, leading to the development of various therapeutic options. Little evidence for the efficacy of most of these treatments is currently available, indicating a need for further investigations.

Keywords: Pruritus, Cholestasis, Autotaxin, Opioid receptor antagonist

Core tip: Pruritus is a symptom influencing the quality of life in patients with chronic liver diseases especially with cholestatic liver diseases. Complex underlying mechanisms have been identified and various therapeutic options developed. More evidence is needed for these treatments, as well as improvements in their tolerability.