Scratching the surface: A systematic review of modern approaches to diagnosing and treating cholestatic pruritus

doi:10.13105/wjma.120937

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World Journal of Meta-Analysis

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2308-3840

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Meta-Anal. Sep 18, 2026; 14(3): 120937
Published online Sep 18, 2026. doi: 10.13105/wjma.120937

Table 3 Pharmacologic therapies for cholestatic pruritus

Therapy	Mechanism	Evidence	Key adverse effects
Cholestyramine	Bile acid binding	Low	GI intolerance
Rifampin	PXR induction	Strong	Hepatotoxicity
Naltrexone	Opioid blockade	Moderate	Withdrawal symptoms
Sertraline	Central modulation	Low-moderate	Sexual dysfunction, weight gain
Fibrates	PPAR activator	Strong (recent)	Myalgia, transaminitis
IBAT inhibitors	BA circulation blockade	Strong (recent)	Diarrhea

IBAT: Ileal bile acid transporter; PXR: Pregnane X receptor; PPAR: Peroxisome proliferator-activated receptor; BA: Bile acid; GI: Gastrointestinal.

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Citation: Liu C, Elangovan A, Diaz DJ, Petrova L, Yekula A, Twohig P. Scratching the surface: A systematic review of modern approaches to diagnosing and treating cholestatic pruritus. World J Meta-Anal 2026; 14(3): 120937
URL: https://www.wjgnet.com/2308-3840/full/v14/i3/120937.htm
DOI: https://dx.doi.org/10.13105/wjma.120937

Liu C, Elangovan A, Diaz DJ, Petrova L, Yekula A, Twohig P. Scratching the surface: A systematic review of modern approaches to diagnosing and treating cholestatic pruritus. World J Meta-Anal 2026; 14(3): 120937 [DOI: 10.13105/wjma.120937]

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