Seladelpar Improved Itch, Itch‐Related Sleep Disturbance and Measures of Fatigue in Patients With Primary Biliary Cholangitis and Pruritus in the Phase 3 <scp>RESPONSE</scp> Trial

BACKGROUND: Pruritus and fatigue impose a significant burden on patient quality of life in primary biliary cholangitis (PBC). In the Phase 3 RESPONSE trial (NCT04620733), seladelpar, a potent and selective PPARδ agonist, significantly improved markers of cholestasis and pruritus. AIMS: Here, we provide additional details on the effects of seladelpar on pruritus and quality of life. METHODS: In RESPONSE, patients with PBC and an inadequate response or intolerance to ursodeoxycholic acid were randomised 2:1 to seladelpar 10 mg or placebo for 12 months. Changes in severity of pruritus by the numeric rating scale (NRS) and changes in 5-D Itch and PBC-40 in patients with moderate to severe itch (NRS ≥ 4), severe itch (NRS ≥ 7) and clinically significant itch (PBC-40 itch ≥ 7) at baseline were evaluated. RESULTS: In patients with baseline NRS ≥ 4, mean NRS improved from the moderate to mild range with seladelpar, but not placebo. Bodily distribution of itch was reduced with seladelpar based on the 5-D itch distribution domain. Itch-related sleep disturbance was consistently improved with seladelpar across populations, and measures of fatigue were improved versus placebo in patients with severe itch at baseline. Patients without itching tended to remain free from itching with seladelpar, consistent with fewer adverse events of pruritus with seladelpar versus placebo. CONCLUSION: In addition to an established anticholestatic effect, seladelpar improved pruritus severity and distribution, itch-related sleep disturbance and measures of fatigue in patients with PBC and pruritus, indicating clinically relevant improvements in itch and other quality of life benefits.