Treatment of Primary Biliary Cholangitis with Cholestatic Pruritus

Cholestatic pruritus is a characteristic symptom of primary biliary cholangitis (PBC) and one of its most burdensome manifestations, significantly impairing patients' health-related quality of life.

This protocol is for patients with PBC who are experiencing cholestatic pruritus. Current guidance recommends a structured, stepwise approach to managing this symptom — progressing through successive therapeutic options when earlier steps prove insufficient.

Treatment Approach

When earlier steps in the stepwise approach have not provided adequate relief, a second-line pharmacological option — rifampicin — enters consideration. The complete sequencing, criteria for escalation, and full monitoring guidance are available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1002/hep.32117

Pruritus is one of the characteristic cholestatic symptoms in PBC and results in impaired health-related quality of life (HRQoL).
EASL recommends treating pruritus using a stepwise approach.
EASL recommends rifampicin as a second-line therapy for pruritus, usually at a dose of 150 mg–300 mg daily.

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