Pruritus is common in patients with chronic liver disease and is improved by nalfurafine hydrochloride

Pruritus is known to be a common complication in hepatitis patients, but the exact frequency and degree are not fully elucidated. Thus, we evaluated pruritus of 450 patients with chronic liver disease at our hospital. Pruritus was observed in 240 (53%) of the patients. Pruritus was significantly associated with males (OR=1.51, P=0.038) and patients with alkaline phosphatase (ALP)>= 200 U/L (OR=1.56, P=0.0495) and was significantly less in HBsAg-positive patients (OR=0.449, P=0.004). Seasonally, there was no difference in the frequency of pruritus between summer and winter. Of the 24 refractory pruritus patients treated with nalfurafine, 17 (71%) indicated improvement of itch, which is defined as a decrease in the visual analog scale score >= 30 mm. Pruritus was improved by nalfurafine both during daytime and nighttime in the Kawashima's scores evaluation. All patients who received nalfurafine exhibited improved Kawashima's scores >= 1 point during the daytime or nighttime. In conclusion, pruritus occurred in >50% of patients with chronic liver disease, and predictors of pruritus were males and ALP >= 200 U/L. Nalfurafine may be useful for pruritus, regardless of whether daytime or nighttime.