Assessment of <scp>PBC</scp> Pruritus From the <scp>ITCH</scp> ‐E Study: Quality of Life, Productivity, and Treatment Experiences
Cynthia Levy, Zobair M. Younossi, Marlyn J. Mayo, Andreas E. Kremer, Jennifer Pate, Jonathan Ieyoub, Rebekah Zincavage, Brad Padilla, Diane Ito, Carla Perez
Abstract
BACKGROUND & AIMS: This US-based study assessed the impact of pruritus on health-related quality of life (HRQoL) and treatment experiences of people with primary biliary cholangitis (PBC). METHODS: Patients with PBC were recruited from a physician panel and patient advocacy group. Participants were grouped by the Pruritus Numerical Rating Scale (NRS): No/Mild Pruritus (NMP, NRS < 4) and Moderate/Severe Pruritus (MSP, NRS ≥ 4). Participants completed the 5-D Itch, PBC-40, EQ-5D-5L, Chronic Liver Disease Questionnaire (CLDQ-PBC), Work Productivity and Activity Impairment (WPAI), and Functional Assessment of Chronic Illness Therapy - Fatigue Scale, Version 4 (FACIT-Fatigue) questionnaires, and PBC treatment experiences questions. Differences were analysed using regression models for confounders. An MSP group subset responded to voice questions. RESULTS: The sample included 40 NMP and 50 MSP participants, with 85% and 80% females, respectively. The MSP group reported significantly worse outcomes on 5-D Itch, EQ-5D Index, PBC-40 (all domains besides Emotional), FACIT-Fatigue, and CLDQ-PBC total scores compared to the NMP group (all p < 0.05). The MSP group reported significantly greater activity impairment due to PBC (57%) than the NMP group (36%; p < 0.001). The MSP group had a lower employment rate (42%) than the NMP group (53%). Fewer than 25% of the MSP group were receiving itch treatment. CONCLUSIONS: Individuals with PBC and pruritus report limited pruritus treatment use and minimal itch relief. Those with moderate/severe pruritus experience a greater HRQoL burden and reduced activity compared to those with mild/no pruritus. This highlights the need for effective treatments that ameliorate pruritus in patients with PBC.