2023 Webinar: Mechanisms and Current/Emerging Therapies of Fatigue & Pruritus in ALD-Webinar Recording

Video Transcription

Video Summary

The webinar focused on the mechanisms and emerging therapies for fatigue and pruritus in cholestatic and autoimmune liver diseases. Dr. Mark Swain discussed the conceptual framework for fatigue, dividing it into peripheral fatigue and central fatigue. He highlighted that in autoimmune liver diseases, central fatigue is more common and is associated with changes in brain function. He mentioned that fatigue is the most common symptom reported by people with autoimmune liver diseases and can have a significant impact on quality of life. Dr. Swain also discussed the objective changes in brain structure, neural activity, and neural connectivity that have been observed in patients with PBC and fatigue. He mentioned that current therapies for PBC-related fatigue, such as UDCA and albatolic acid, do not improve fatigue. However, emerging therapies like salidelpart and cetaxanthinib show promise in improving fatigue symptoms in PBC patients. Dr. Andreas Kramer focused on the pathophysiology and clinical burden of pruritus in liver diseases. He discussed the sensory pathways involved in itch perception and highlighted the role of cholestatic substances, such as bile acids and cytokines, in activating sensory neurons and causing pruritus. Dr. Kramer also discussed the various treatments for pruritus, including non-drug measures, such as topical therapies and UVB therapy, as well as pharmacological treatments, such as anion exchange resins, rifampicin, antihistamines, PPAR agonists, and kappa-opioid receptor agonists. He mentioned that new treatments, such as the Ibat inhibitors and peripheral acting kappa-opioid receptor agonists, show promise in reducing pruritus. Overall, the webinar provided valuable insights into the mechanisms underlying fatigue and pruritus in cholestatic and autoimmune liver diseases and highlighted emerging therapies that may improve these symptoms.

Keywords

fatigue

pruritus

cholestatic liver diseases

autoimmune liver diseases

central fatigue

peripheral fatigue

brain function

PBC

treatments

kappa-opioid receptor agonists