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[Comment] An appealing new agent for treating cholestatic pruritus

Management of cholestatic pruritus is challenged by the uncertainty of its pathogenesis, which is related to various components of bile, but could also be mediated by increased opioidergic neurotransmission and other pathways.1 Ursodeoxycholic acid (UDCA) does not ameliorate cholestatic itch except in intrahepatic cholestasis of pregnancy. Resins such as cholestyramine and colestipol are widely used as first-line treatments although the evidence base for these interventions is small.2 Moreover, patients can have poor tolerance because of taste and abdominal disturbances, and might discontinue therapy.