Assessment of PBC Pruritus From the ITCH-E Study: Quality of Life, Productivity, and Treatment Experiences

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.