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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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Systematic Reviews

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

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Figure 1 Mechanisms of anti-pruritic therapies. PXR: Pregnane X receptor; IBAT: Ileal bile acid transporter; PPAR: Peroxisome proliferator-activated receptor.

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Figure 2 Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram.

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Figure 3 Diagnostic approach to cholestatic pruritus. NRS: Numerical Rating Scale; VAS: Visual Analogue Scale; GGT: Gamma-glutamyl transferase; RUQ: Right upper quadrant; US: Ultrasound; MRCP: Magnetic resonance cholangiopancreatography; ERCP: Endoscopic retrograde cholangiopancreatography; PSC: Primary sclerosing cholangitis; FIB-4: Fibrosis-4 index; APRI: Aspartate aminotransferase/platelet ratio index; ICP: Intrahepatic cholestasis of pregnancy.

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Figure 4 Proposed multidisciplinary model of care.

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Figure 5 Stepwise management algorithm for cholestatic pruritus. PBC: Primary biliary cholangitis; PSC: Primary sclerosing cholangitis; SSC: Secondary sclerosing cholangitis; IBAT: Ileal bile acid transporter; UVB: Ultraviolet B; PFIC: Progressive familial intrahepatic cholestasis; ICP: Intrahepatic cholestasis of pregnancy; UDCA: Ursodeoxycholic acid.

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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