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Pathogenesis and Treatment of Pruritus in Cholestasis

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Abstract

Pruritus is an enigmatic, seriously disabling symptom accompanying cholestatic liver diseases and a broad range of other disorders. Most recently, novel itchspecificneuronal pathways, itch mediators and their relevant receptors have been identified. In addition, new antipruritic therapeutic strategies have been developed and/or are under evaluation. This review highlights recent experimental and clinical findings focusing on the pathogenesis and actual treatment of pruritus in cholestatic liver disease. Evidence-based therapeutic recommendations, including the use of anion exchange resins cholestyramine, colestipol and colesevelam, the microsomal enzyme inducer rifampicin, the opioid receptor antagonists naltrexone and naloxone, and the serotonin reuptake inhibitor sertraline, are provided.

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Acknowledgements

The authors thank Gustav Paumgartner (Munich) for critical review of the article. No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Kremer, A.E., Beuers, U., Oude-Elferink, R.P.J. et al. Pathogenesis and Treatment of Pruritus in Cholestasis. Drugs 68, 2163–2182 (2008). https://doi.org/10.2165/00003495-200868150-00006

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