Podcasts about pruritus

Life's an itch sometimes….am I right? Pruritus can pick apart the fabric of one's life as both a symptom of a primary skin disease or even as a disease unto... The post From Rags to Itches: The Evolution of Topical and Systemic Options for Pruritus appeared first on JDDonline - Journal of Drugs in Dermatology.

In this podcast, expert faculty, Dr Stuart Gordon and Dr Nancy Reau, use an illustrative patient case to explore the roles of ALP and other biochemical markers in PBC management, and explain what to expect from treatment. Topics covered include: How baseline ALP can affect ALP normalization after second-line treatment with elafibranor and seladelparPotential outcomes if ALP normalization cannot be achievedThe importance of managing fatigue, pruritus, and sleep disturbances independently of the biochemical responsePresenters:Stuart C. Gordon, MDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganNancy Reau, MDProfessor of MedicineRichard B. Capps Chair of HepatologyChief, Section of HepatologyAssociate Director, Solid Organ TransplantationRush University Medical CenterChicago, IllinoisTo learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.  

Supported by Gilead Sciences Europe Ltd who provided funding for this content and is intended for healthcare professionals. Gilead Sciences Europe Ltd was not involved in the creation of this content. The views and opinions expressed in this podcast are those of the individual speakers and do not necessarily reflect those of Gilead Sciences Europe Ltd or EMJ. Note that not all treatments discussed in this episode may have received market approval. Please refer to your local marketing authorisation and prescribing practices for guidance. The speakers received honoraria. Tune into this episode hosted by Hannah Moir, which discusses what PBC is, and key takeaways from the AASLD conference.

Dr. Mellar Davis discusses the joint guideline from MASCC, ASCO, AAHPM, HPNA, and NICSO on opioid conversion in adults with cancer. He reviews the limited evidence, and the formal consensus process used to develop the guideline. He shares the key recommendations on pre-conversion assessment, how opioid conversion should be conducted, including opioid conversion ratios, and post-conversion assessment. We touch on gaps and questions in the field and the impact of these new recommendations.  Read the full guideline, “Opioid Conversion in Adults with Cancer: MASCC-ASCO-AAHPM-HPNA-NICSO Guideline” at www.asco.org/supportive-care-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/supportive-care-guidelines. Read the full text of the guideline in the Supportive Care in Cancer, https://link.springer.com/article/10.1007/s00520-025-09286-z   Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Mellar Davis from Geisinger Medical Center, lead author on “Opioid Conversion in Adults with Cancer: Multinational Association of Supportive Care and Cancer, American Society of Clinical Oncology, American Academy of Hospice and Palliative Medicine, Hospice and Palliative Nurses Association, Network Italiano Cure di Supporto and Oncologia Guideline.” Thank you for being here today, Dr. Davis. Dr. Mellar Davis: Thank you. I'm glad to be here. Brittany Harvey Before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Davis, who has joined us here today, are available online with the publication of the guideline, which is linked in our show notes. So then, to dive into the content here, Dr. Davis, can you provide an overview of both the scope and purpose of this guideline on opioid conversion in people with cancer? Dr. Mellar Davis: This is an important topic in management of cancer pain and this topic came up as a result of a survey that MASCC had done, which involved 370 physicians in 53 countries. They were queried about how they change or convert one opioid to another, which is a common practice, and we found that there was quite a divergence in opioid conversion ratios. To step back a little bit, about two thirds of patients with advanced cancer have moderate to severe pain and most of the time they're managed by opioids. But about 20% or 40% require a switch either because they have an adverse reaction to it or they don't respond to it, or the combination of both. Rarely, it may be that they need a route change, perhaps because they have nausea or vomiting. So, the opioid conversion works basically because of the complexity of the new opioid receptor which has at least four exons to it as a result of that non-cross tolerance between opioids. As a result of the survey, we convened a group of specialists, 14 international specialists, to look to see if we could develop an international guideline. And we did a systematic review which involved viewing 21,000 abstracts and we came up with 140 randomized trials and 68 non-randomized trials. And after reviewing the data, we found that the data was really not strong enough to provide a guideline. As a result, ASCO, MASCC, the AAHPM, the HPNA and the Italian Group formed a supportive network that allowed us then to do a Delphi guideline based upon ASCO modified criteria for doing Delphi guidelines. And so we then involved 27 additional international experts informing the guideline to it. And this guideline is then the result of the Delphi process. It consists basically of a pre-conversion ratio recommendations, conversion ratios, which is actually a major contribution of this guideline, and then what to do after converting someone to another opioid. Our target audience was not only oncologists, but also we wanted to target nurses, pharmacists, hospitalists, primary care physicians, patients and caregivers. Brittany Harvey: I appreciate that background information, particularly on the evidence that is underpinning this and the lack of quality of evidence there, which really transformed this into a formal consensus guideline. We're glad to have all of these organizations coming together to collaborate on this guideline. So then next I'd like to review the key recommendations. So starting with, what is recommended for pre-conversion assessment? Dr. Mellar Davis: In regards to pre-conversion, physicians and clinicians need to be aware of pain phenotypes. That is, there are pains that are more opioid refractory than others, such as neuropathic pain, hence, they may be more resistant to the opioid that you're converting to. One needs to be aware of the fact that patients may not be compliant, they're either afraid of opioids not taking what was prescribed, so it's important to query patients about whether they are taking their opioid as prescribed. Occasionally, there are patients who will divert their medication for various reasons. Pain may be poorly controlled also because of dosing strategies that are poorly conceived, in other words, giving only ‘as needed' opioids for continuous cancer pain. And there are rare circumstances where an opioid actually induces pain and simply reducing the opioid actually may improve the pain. The other issue may be cancer progression. So that poorly controlled pain or rapidly increasing pain may actually be a result of progressive cancer and changing treatment obviously will be important. And you need to assess the pain severity, the quality of the pain, the radiating localizing effects, which does require not only a physical exam but also radiographic examinations. But the other thing that's very important in opioid conversions are pain scales with function. A significant number of patients don't quite understand a numerical scale which we commonly use: 0 to 10, with 10 being severe pain and 0 being no pain. They may in fact focus more on function rather than on pain severity or pain interference with daily activities or roles. Sometimes patients will say, “Oh, my pain is manageable,” or “It's tolerable,” rather than using a numerical scale. Choices of opioids may be based on cost, drug-drug interactions, organ function, personal history or substance use disorder so that one will want to choose an opioid that's safe when converting from one to another. And obviously social support and having caregivers present and understanding the strategy in managing pain will be important. Brittany Harvey: Thank you, Dr. Davis, for reviewing those pre-conversion assessment considerations and particularly the challenges around some of those. So, following this pre-conversion assessment, what are the recommendations on how opioid conversion should be conducted? Dr. Mellar Davis: Opioid conversions are basically the safe dose. People have used the term ‘equianalgesia', but the panel and the consensus group felt that that would be inappropriate. So a conversion ratio is the dose at which the majority of patients will not experience withdrawal or adverse effect. It would be the safe dose. Thereafter, the dose will need to be adjusted. So, in converting, that's only the first step in managing pain, the doses need to be adjusted to the individual thereafter. There are a significant number of conversions that are done indirectly, that is that there has not been a study that has looked at a direct conversion from one opioid to another in which one needs to convert through another opioid. We call that a ‘morphine equivalent daily dose'. So, most of the time a third opioid is used in the conversion. It allows you then to convert when there hasn't been a direct study that has looked at conversion between those two opioids, but it is less accurate and so one has to be a little bit more careful when using morphine daily equivalents. We found, and I think this is the major advantage to the guideline, is that commonly used opioids - oxycodone, morphine, hydromorphone - we did establish conversion ratios to which we found in the MASCC guideline they were widely divergent and hope that actually, internationally, they will be adopted. We also found some conversion ratios for second-line opioids. However, we felt also that an opioid like methadone, which has a unique pharmacology, should be left to experts and that experts should know at least several ways of converting from morphine usually to methadone. There is what appears to be a dose-related increased potency of methadone relative to morphine, which makes it more difficult, particularly at higher doses, to have an accurate conversion ratio. Most patients will have transient flares of pain. We came up with two suggestions. One is using a 10 or 15% of the around-the-clock dose for the breakthrough dose, but we also realized that there was a poor correlation between the around-the-clock dose and the dose used for transient flares of pain. And so the breakthrough dose really needs to be adjusted to the individual responses. There was also a mention of buprenorphine. One of the unique things about buprenorphine is that if you go from high doses of a drug like morphine to buprenorphine in a stop-start dosing strategy, you can precipitate withdrawal. And so one has to be careful and have some experience in using buprenorphine, which can be an effective analgesic. Brittany Harvey: Yes, I think that the conversion ratios that you mentioned that are in Table 3 in the full guideline are a really useful tool for clinicians in practice. And I appreciate the time that the panel and the additional consensus panel went through to develop these. I think it's also really key what you mentioned about these not being equianalgesic doses and the difficulties in some of these conversions and when people need to really look to specialists in the field. So then, following opioid conversion, what assessments are recommended post-conversion? Dr. Mellar Davis: Post-conversion, probably the cardinal recommendation is close observation for response and for toxicity. And I think that probably summarizes the important parts of post-conversion follow up. So assessment should be done 24-48 hours after conversion and patients followed closely. Assessment scales should include patient personalized goals. Now, it used to be in the past that we had this hard stop about a response being below 4 on a 0 to 10 scale, but each patient has their own personal goals. So they gauge the pain severity and their function based upon response. So a patient may function very well at “a severity of 5” and feel that that is their personal goal. So I think the other thing is to make sure that your assessment is just not rote, but it's based upon what patients really want to achieve with the opioid conversion. The average number of doses per day should be assessed in the around-the-clock dose so those should be followed closely. Adverse effects can occur and sometimes can be subtle. In other words, a mild withdrawal may produce fatigue, irritability, insomnia and depression. And clinicians may not pick up on the fact that they may be actually a bit under what patients have or they're experiencing withdrawal syndrome. It's important to look for other symptoms which may be subtle but indicating, for instance, neurotoxicity from an opioid. For instance, visual hallucinations may not be volunteered by patients. They may transiently see things but either don't associate with the opioid or are afraid to mention them. So I think it's important to directly query them, for instance, about visual hallucinations or about nightmares at night. Nausea can occur. It may be temporary, mild, and doesn't necessarily mean that one needs to stop the second opioid. It may actually resolve in several days and can be treated symptomatically. Pruritus can occur and can be significant. So close observation for the purposes of close adjustments are also necessary. As we mentioned, you want to start them on an around-the-clock of breakthrough dose, but then assess to see what their response is and if it's suboptimal then you'll need to adjust the doses based both upon the around-the-clock and the breakthrough dose or the dose that's used for breakthrough pain. Also looking at how patients are functioning, because remember that patients frequently look at pain in terms of function or interference with their roles during the day. So, if patients are able to do more things, that may, in fact, be the goal. Brittany Harvey: Thank you for reviewing all of these recommendations across pre-conversion assessment, how opioid conversion should be conducted, including conversion ratios, and what assessments are recommended after opioid conversion. I think it's really important to be watching for these adverse events and assessing for response and keeping in mind patient goals. So, along those lines, how will these guideline recommendations impact both clinicians and people with cancer? And what are the outstanding questions we're thinking about regarding opioid conversion? Dr. Mellar Davis: I think it's important to have a basic knowledge of opioid pharmacology. There's, for instance, drugs that are safer in liver disease, such as morphine, hydromorphone, which are glucuronidated. And there are opioids that are safer in renal failure, such as methadone and buprenorphine, which aren't dependent upon renal clearance. I think knowing drug-drug interactions are important to know. And sometimes, for instance, there may be multiple prescribers for a patient. The family physician's prescribing a certain medication and the oncologist is another, so being aware of what patients are on, and particularly over-the-counter medications which may influence opioid pharmacokinetics. So complementary medications, for instance, being aware of cannabis, if patients are using cannabis or other things, I think, are important in this. There are large gaps and questions and that's the last part of the guideline that we approach or that we mentioned that I think are important to know. And one is there may be ethnic differences in population in regards to clearance or cytochrome frequencies within communities or countries, which may actually alter the conversion ratios. This has not been explored to a great extent. There's opioid stigmata. So we are in the middle of an opioid crisis and so people have a great fear of addiction and they may not take an opioid for that reason, or they may have a relative who's been addicted or had a poor experience. And this may be particularly true for methadone and buprenorphine, which are excellent analgesics and are increasingly being used but may in fact have the stigmata. There are health inequalities that occur related to minority groups that may in fact not get the full benefit of opioid conversions due to access to opioids or to medical care. Age, for instance, will cause perhaps differences in responses to opioids and may in fact affect conversion ratios. And this may be particularly true for methadone, which we have not really explored to a great extent. And finally, the disease itself may influence the clearance or absorption of an opioid. So for a sick patient, the opioid conversion ratio may be distinctly different than in a healthy individual. This is particularly seen with transdermal fentanyl, which is less well absorbed in a cachectic patient, but once given IV or intravenously has a much longer half life due to alterations in the cytochrome that clears it. And so conversion ratios have frequently been reported in relatively healthy individuals with good organ function and not that frequently in older patient populations. So just remember that the conversion ratios may be different in those particular populations. Brittany Harvey: Yes. So I think a lot of these are very important things to consider and that managing cancer pain is key to quality of life for a lot of patients and it's important to consider these patient factors while offering opioid conversion. I want to thank you so much for your work to review the existing literature here, develop these consensus-based recommendations and thank you for your time today, Dr. Davis. Dr. Mellar Davis: Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

How do you decide when to move from first-line to second-line treatment for primary biliary cholangitis (PBC)? In this podcast, listen as experts Alan Bonder, MD, AGAF, and Aparna Goel, MD, discuss this question and more, including:How and when to measure treatment responseEvidence-based goals of therapyConsiderations for second-line treatmentNew agents for second-line treatment: PPAR agonistsPresenters:Alan Bonder, MD, AGAFAssociate Professor of MedicineMedical Director of Liver TransplantDepartment of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBoston, MassachusettsAparna Goel, MDAssociate Clinical Professor of MedicineDivision of Gastroenterology and HepatologyStanford UniversityPalo Alto, CaliforniaContent based on an online CME program supported by independent educational grants from Gilead Sciences, Inc., and Ipsen Biopharmaceuticals, Inc​.To learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.Supported by educational grants from Gilead Sciences, Inc. and Ipsen Biopharmaceuticals, Inc

In this podcast, listen as experts Alan Bonder, MD, AGAF, and Aparna Goel, MD, discuss how they assess the symptoms of primary biliary cholangitis (PBC) and explore how new therapeutic agents may help alleviate symptom burden. Topics include:Strategies and tools for assessing pruritusNonpharmacologic and pharmacologic management of pruritusSecond-line agents and their impact on pruritusInvestigational treatments for pruritusPresenters:Alan Bonder, MD, AGAFAssociate Professor of MedicineMedical Director of Liver TransplantDepartment of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBoston, MassachusettsAparna Goel, MDAssociate Clinical Professor of MedicineDivision of Gastroenterology and HepatologyStanford UniversityPalo Alto, CaliforniaContent based on an online CME program supported by independent educational grants from Gilead Sciences, Inc., and Ipsen Biopharmaceuticals, Inc​.To learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.

In this podcast, Sonal Kumar, MD, MPH, meets with patient advocate Maria Morais to discuss actionable steps that healthcare providers can incorporate into the care of people with primary biliary cholangitis (PBC). Listen as they discuss:The chronic nature of PBCGoing beyond biochemical markers to assess and address symptoms such as fatigue and pruritusThe importance of referral to patient support groupsPresenters:Sonal Kumar, MD, MPHAssistant Professor of MedicineDirector, General Gastroenterology and HepatologyWeill Cornell Medical CollegeNew York, New YorkMaria G. Morais, RNVP Patient AdvocacyCanadian PBC SocietyToronto, CanadaTo learn more, see the program Hear Me: Patient Perspectives on PBC

CME credits: 0.25 Valid until: 31-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/no-patient-left-behind-advancing-ckd-associated-pruritus-care/26637/ Patients with chronic kidney disease-associated pruritus (CKD-aP) often face delays in diagnosis and treatment, as well as potential side effects from some prescribed medicines. Tune in as our experts dive into the burden of CKD-aP symptoms and break down the long-term outcomes and benefits of new and emerging treatments.=

In this episode, Sonal Kumar, MD, MPH, discusses key findings from primary biliary cholangitis (PBC) studies presented at AASLD 2024, including:ELATIVE, a phase III trial of elafibranor for PBCRESPONSE, a phase III trial of seladelpar for PBCASSURE, another phase III trial of seladelpar for PBCPresenter:Sonal Kumar, MD, MPHDirector, Clinical Gastroenterology and HepatologyAssistant Professor of MedicineWeill Cornell Medical CollegeNew York, New YorkLink to full program:https://bit.ly/41tvSDuGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

In this episode, Sonal Kumar, MD, MPH, discusses key findings from primary biliary cholangitis (PBC) studies presented at AASLD 2024, including:ELATIVE, a phase III trial of elafibranor for PBCRESPONSE, a phase III trial of seladelpar for PBCASSURE, another phase III trial of seladelpar for PBCPresenter:Sonal Kumar, MD, MPHDirector, Clinical Gastroenterology and HepatologyAssistant Professor of MedicineWeill Cornell Medical CollegeNew York, New YorkLink to full program:https://bit.ly/41tvSDuGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

In this episode, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with primary biliary cholangitis (PBC), discuss the burden of pruritus in PBC and the impact it has on quality of life, including both physical and mental health, from a patient's perspective. Presenters:Marlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUT Southwestern Medical CenterDallas, TexasStuart C. Gordon, MDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganPam Rivard, RNPerson living with PBC Link to full program: https://bit.ly/4gDGDaB

Although there is currently no FDA-approved treatment for pruritus in primary biliary cholangitis (PBC), symptoms can be mitigated with nonpharmacologic or pharmacologic agents. In this episode, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with PBC, discuss the clinical management of pruritus in PBC, including:Pruritus assessment toolsOptimal use of tools, including frequency of assessmentCurrent management of pruritusNonpharmacologic interventionsPharmacologic agentsStrategies to optimize assessment and management of pruritusCollaborative careDevelopment of a treatment planOngoing assessment and adjustment of therapyResources and support for patientsPresenters:Marlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUT Southwestern Medical CenterDallas, TexasStuart C. Gordon, MDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganPam Rivard, RNPerson living with PBCLink to full program: https://bit.ly/3Dnfb2E

Clinical gaps in the treatment of pruritus in primary biliary cholangitis (PBC) remain. In this episode, taken from a recent symposium, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with PBC, discuss emerging therapies currently in clinical trials for the management of this disease that can dramatically affect patients' quality of life.Listen as they discuss:Gaps in current managementPatient perspectives: why we should not dismiss itching as an underlying psychologic problemPPAR agonists and how they affect pruritusBEZURSO and FITCH ELATIVEENHANCE and RESPONSEIBATs (inhibitors of bile acid transport)GLIMMERCommon questionsPresenters:Marlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUT Southwestern Medical CenterDallas, TexasStuart C. Gordon, MDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganPam Rivard, RNPerson living with PBCLink to full program: https://bit.ly/3Dnfb2E

In this episode, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with primary biliary cholangitis (PBC), discuss the burden of pruritus in PBC and the impact it has on quality of life, including both physical and mental health, from a patient's perspective.Presenters:Marlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUT Southwestern Medical CenterDallas, TexasStuart C. Gordon, MDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganPam Rivard, RNPerson living with PBCLink to full program: https://bit.ly/4gDGDaB

Although there is currently no FDA-approved treatment for pruritus in primary biliary cholangitis (PBC), symptoms can be mitigated with nonpharmacologic or pharmacologic agents. In this episode, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with PBC, discuss the clinical management of pruritus in PBC, including:Pruritus assessment toolsOptimal use of tools, including frequency of assessmentCurrent management of pruritusNonpharmacologic interventionsPharmacologic agentsStrategies to optimize assessment and management of pruritusCollaborative careDevelopment of a treatment planOngoing assessment and adjustment of therapyResources and support for patientsPresenters:Marlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUT Southwestern Medical CenterDallas, TexasStuart C. Gordon, MDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganPam Rivard, RNPerson living with PBCLink to full program: https://bit.ly/3Dnfb2E

Clinical gaps in the treatment of pruritus in primary biliary cholangitis (PBC) remain. In this episode, taken from a recent symposium, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with PBC, discuss emerging therapies currently in clinical trials for the management of this disease that can dramatically affect patients' quality of life.Listen as they discuss:Gaps in current managementPatient perspectives: why we should not dismiss itching as an underlying psychologic problemPPAR agonists and how they affect pruritusBEZURSO and FITCH ELATIVEENHANCE and RESPONSEIBATs (inhibitors of bile acid transport)GLIMMERCommon questionsPresenters:Marlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUT Southwestern Medical CenterDallas, TexasStuart C. Gordon, MDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganPam Rivard, RNPerson living with PBCLink to full program: https://bit.ly/3Dnfb2E

CME credits: 0.25 Valid until: 18-10-2025 Claim your CME credit at https://reachmd.com/programs/cme/unveiling-the-latest-advancements-in-ckd-associated-pruritus-care/26636/ Chronic kidney disease-associated pruritus (CKD-aP) is an underreported and underdiagnosed condition that affects a significant proportion of patients with advanced kidney disease undergoing dialysis. But with the approval of difelikefalin, many patients have experienced symptom improvement not only in their itching but in their quality of life. Join the experts as they review the newest real-world data and clinical results of difelikefalin presented at ERA. =

Nemolizumab, pruritis, and Dr. Shawn Kwatra! - Food and atopic dermatitis - Dermasphere clip show: episodes 131-140! Find Dr. Shawn Kwatra on social media at DrShawnKwatra Want to donate to the cause? Do so here! Donate to the podcast: uofuhealth.org/dermasphere Check out our video content on YouTube: www.youtube.com/@dermaspherepodcast and VuMedi!: www.vumedi.com/channel/dermasphere/ The University of Utah's Dermatology ECHO: ⁠physicians.utah.edu/echo/dermatology-primarycare - ⁠ Connect with us! - Web: ⁠dermaspherepodcast.com/⁠ - Twitter: @DermaspherePC - Instagram: dermaspherepodcast - Facebook: www.facebook.com/DermaspherePodcast/ - Check out Luke and Michelle's other podcast, SkinCast! ⁠healthcare.utah.edu/dermatology/skincast/⁠ Luke and Michelle report no significant conflicts of interest… BUT check out our friends at: - ⁠Kikoxp.com ⁠(a social platform for doctors to share knowledge) - ⁠www.levelex.com/games/top-derm⁠ (A free dermatology game to learn more dermatology!

Ever experienced a tingling, itching, or crawling sensation under your skin at night? This isn't just your imagination – it's a real condition known as Nocturnal Pruritus.In this episode, we get into the causes of this bizarre sensation. From tingling and numbness to the feeling of invisible bugs, we explore paresthesia, a medical phenomenon that's often more than just a weird feeling.We'll also uncover how this sensation is linked to conditions like Adrenal Fatigue Syndrome (AFS), emphasizing why these symptoms shouldn't be ignored. Your body could be signaling a deeper health issue!Trying to find an integrative medicine or functional medicine doctor who understands what you're going through? Lam Clinic does Telemedicine all over the world and is only a phone call away.1. Educate yourself by visiting our website: www.lamclinic.com2. Call our office at 714-709-8000 to schedule an appointment.FIND US ONLINE HERE:» Website: https://www.lamclinic.com/» Facebook: https://www.facebook.com/lamclinic» Instagram: https://www.instagram.com/lam_clinic/» Tiktok: https://www.tiktok.com/@lamclinic» YouTube: https://www.youtube.com/LAMCLINIC

In this episode, Stuart C. Gordon, MD, FACP, FACG, AGAF, FAASLD; Marlyn J. Mayo, MD; and Brenda Remo discuss the patient experience with cholestatic pruritus in PBC.Listen to their conversation on how people describe the experience of cholestatic pruritus, the extent to which pruritus negatively affects quality of life, and the importance of educating healthcare professionals on this important symptom of PBC.Presenters:Stuart C. Gordon, MD, FACP, FACG, AGAF, FAASLDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford Health Detroit, MichiganMarlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUniversity of Texas SouthwesternDallas, TexasBrenda RemoPerson living with PBCDownloadable slides: https://bit.ly/3LHHiufProgram: https://bit.ly/4fBLQ3lTo get access to all of our new podcast episodes, subscribe to the CCO podcast channels on Apple Podcasts, Google Podcasts, or Spotify.

In this episode, Stuart C. Gordon, MD, FACP, FACG, AGAF, FAASLD; Marlyn J. Mayo, MD; and Brenda Remo discuss strategies for optimizing PBC pruritus care in the clinic setting.Listen to their conversation on how important it is to ask patients about their pruritus, validate their symptoms and feelings, and offer treatment options framed with realistic expectations.Presenters:Stuart C. Gordon, MD, FACP, FACG, AGAF, FAASLDProfessor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford Health Detroit, MichiganMarlyn J. Mayo, MDProfessor of Internal MedicineDivision of Digestive & Liver DiseasesUniversity of Texas SouthwesternDallas, TexasBrenda RemoPerson living with PBCDownloadable slides: https://bit.ly/3LHHiufProgram: https://bit.ly/4fBLQ3lTo get access to all of our new podcast episodes, subscribe to the CCO podcast channels on Apple Podcasts, Google Podcasts, or Spotify.

Editor's Summary by Anne Rentoumis Cappola, MD, ScM, Associate Editor of JAMA, the Journal of the American Medical Association, for the June 25, 2024, issue.

Dr. Feldman on THE CURSE OF KNOWLEDGE - Doxycycline is better than minocycline - Psychoactive meds in pruritus - Anifrolumab for cutaneous JDM - Want to donate to the cause? Do so here! Donate to the podcast: uofuhealth.org/dermasphere Check out our video content on YouTube: https://www.youtube.com/@dermaspherepodcast and VuMedi!: https://www.vumedi.com/channel/dermasphere/ The University of Utah's Dermatology ECHO: ⁠https://physicians.utah.edu/echo/dermatology-primarycare - ⁠ Connect with us! - Web: ⁠https://dermaspherepodcast.com/⁠ - Twitter: @DermaspherePC - Instagram: dermaspherepodcast - Facebook: https://www.facebook.com/DermaspherePodcast/ - Check out Luke and Michelle's other podcast, SkinCast! ⁠https://healthcare.utah.edu/dermatology/skincast/⁠ Luke and Michelle report no significant conflicts of interest… BUT check out our friends at: - ⁠Kikoxp.com ⁠(a social platform for doctors to share knowledge) - ⁠https://www.levelex.com/games/top-derm⁠ (A free dermatology game to learn more dermatology!

In dieser Folge spricht Dr. Falk Stirkat mit Dr. med. univ. Reingard Glehr. Sie ist Ärztin für Allgemeinmedizin in einer niedergelassenen Praxis in Hartberg, Österreich. 17% der deutschen Bevölkerung leidet an chronischem Juckempfinden. Für Allgemeinärzte ist dies jedoch oft ein unbefriedigendes Symptom, da es sehr vielfältig und oft unspezifisch ist. Wie bei Pruritus-Patienten vorgegangen werden kann, worauf zu achten ist sowie mögliche red flags sind Themen dieser Episode. Den CME-Beitrag zum Podcast finden Sie in Heft 1 der Allgemeinmedizin up2date 2024, Seite 61-80 (DOI 10.1055/a-2188-9076)

Chronic pruritus, defined as itch lasting more than 6 weeks, affects approximately 22% of people in their lifetime. In this JAMA clinical review podcast, dermatologist Daniel C. Butler, MD, from the University of Arizona College of Medicine, joins JAMA Deputy Editor Mary McGrae McDermott, MD, to discuss evaluation and management of chronic pruritus. Related Content: Chronic Pruritus

Please visit nascentmc.com/podcast for all the details.  Go to learnAMAstyle.com for lots of freebies on AMA Style and the use of AI in medical writing and editing Here is information on the latest US FDA approvals, the week of March 11 – March 15, 2024 Liso-cel for CLL/SLL   - The FDA approved lisocabtagene maraleucel (liso-cel; Breyanzi) for adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who have received at least two prior therapies. It is a CAR T-cell therapy that modifies patient's T cells to target tumor antigens. The approval was based on the TRANSCEND CLL 004 study, showing a 20% complete response rate and a median duration of response not reached by the data cutoff. Tislelizumab for Esophageal SCC   - Tislelizumab-jsgr (Tevimbra) received FDA approval for unresectable or metastatic esophageal squamous cell carcinoma (ESCC) patients after prior systemic chemotherapy. The approval was based on the phase 3 RATIONALE 302 trial, which showed significant improvement in overall survival compared to chemotherapy (8.6 months vs. 6.3 months). This marks a critical advancement for patients with limited treatment options after first-line failures. Resmetirom for NASH   - The FDA approved resmetirom (Rezdiffra) for adults with non-cirrhotic non-alcoholic steatohepatitis (NASH) with moderate to advanced fibrosis, to be used alongside diet and exercise. This is the first medication approved to directly address liver damage in NASH patients with significant liver scarring, acting as a partial activator of a thyroid hormone receptor to reduce liver fat. The approval, based on a 54-month trial, used a surrogate endpoint at 12 months to demonstrate improvement in liver scarring and inflammation. Maralixibat for Cholestatic Pruritus   - Maralixibat (Livmarli) oral solution was approved for treating cholestatic pruritus in patients aged 5 years and older with progressive familial intrahepatic cholestasis (PFIC). It is an orally administered ileal bile acid transporter inhibitor, showing efficacy in the Phase 3 MARCH clinical trial across various genetic types of PFIC. Additionally, a higher concentration formulation is under consideration to extend its use to younger PFIC patients. Guselkumab for UC   - A supplemental Biologics License Application (sBLA) has been submitted for guselkumab (Tremfya) for treating adults with moderate-to-severely active ulcerative colitis (UC). The submission is based on the QUASAR program results, demonstrating significant clinical remission at Week 44 compared to placebo. Guselkumab, a novel IL-23 inhibitor, has previously been approved for moderate-to-severe plaque psoriasis and active psoriatic arthritis, marking its potential expansion into UC treatment.  

Why, when one gets an itch, is it almost impossible not to scratch it? Our parents told us not to, but you just can't help it! How do you tell if it's a harmless scratch or a warning sign of something far more sinister? Professor Jonathan Sackier and Dr. Nigel Guest dive deep into the world of pruritus in this episode of Join the Docs.From the nerve pathways that make us squirm, to the more serious systemic diseases, The Docs have got you covered in grease - or perhaps something else to soothe the irritation of Doctor Guest's awful jokes.They'll discuss some of the common causes of itching, from pesky poison ivy to serious liver woes. Eczema, psoriasis, allergic reactions; no itch is left unscratched as we explore treatments and research breakthroughs.They'll uncover the origins of itching, classify it, and give more details on the various medical conditions that surround itching. Whether it's allergies, viruses, fungi, or skin infections causing the itch, The Docs will be discussing everything under the sun.From environmental triggers, to medication-induced itchiness, we'll cover it all, including varicose eczema, chickenpox, athlete's foot, and more. They offer valuable insights into the challenges faced by individuals and families coping with chronic itching conditions, accompanied by practical strategies for alleviating symptoms and fostering support networks.So, grab your back scratcher and join us as we scrape beneath the surface – separating the harmless itches from the more serious.If you want to read more info about this week's episode, head on over to the website where Jonathan goes into more detail here.-----DISCLAIMER: The views and opinions expressed on Join the Docs are those of Dr. Nigel Guest, Jonathan Sackier and other people on our show. Be aware that Join the Docs is not intended to be medical advice, it is for information and entertainment purposes only - please, always take any health concerns to your doctor or other healthcare provider. We respect the privacy of patients and never identify individuals unless they have consented. We may change details, dates, place names and so on to protect privacy. Listening to Join the Docs, interacting on our social media, emailing or writing to us does not establish a doctor patient relationship. To Contact Us: For a deeper dive on this episode's issue, merchandise and exclusive content, head to www.jointhedocs.comFollow us on youtube.com/JoinTheDocs Follow us on instgram.com/JoinTheDocsFollow us on tiktok.com/JoinTheDocsFollow us on facebok.com/JoinTheDocs Follow us on x.com/JoinTheDocs

In this podcast, I'm going to share 15 underlying causes of itching. Pruritus is the medical term for itching. Itching usually involves a superficial nerve that is aggravated to some level. Here are 15 causes of itching: 1. Body lice 2. Scabies 3. Hookworms 4. Herpes 5. Insect bites 6. Yeast infection 7. Poison ivy 8. Tick bites 9. Diabetes 10. Polycythemia 11. Problems with the parathyroid glands 12. Uremia 13. Liver issues 14. Cholestasis 15. Dry skin Itching is often a symptom of diabetes because of circulation problems. Poor circulation causes the nerves to die, which can feel like itching or burning pain and even cause severe pain. Polycythemia is a condition where you have too many red blood cells. This can decrease circulation and the amount of oxygen in your skin, causing itching. The parathyroid gland consists of 4 glands around the thyroid that control calcium. If the thyroid works too hard, you could develop too much calcium in the blood. This can lead to calcification of your skin, which can affect your nerve endings. Liver issues like cirrhosis, hepatitis, or cholestasis can cause itching. You can develop cholestasis if the liver's function is impaired and it can no longer make bile salts. Dry skin is a common cause of itching, often caused by a lack of vitamin A or vitamin D. There is a high correlation between people who have itching and people with liver or gallbladder issues. This is typically caused by irritation to the gallbladder and decreased omega-3 fatty acids. Dietary changes can help eliminate itching. TUDCA, a bile salt that helps thin the bile, has been found to significantly decrease itching in people with cirrhosis. DATA: https://www.sciencedirect.com/science... https://www.ncbi.nlm.nih.gov/pmc/arti... https://www.ncbi.nlm.nih.gov/pmc/arti...

Andreas Kremer, MD, PhD, MHBA - Initiating the Conversation on Itch: Modelling Best Practices in Patient-Centred Care for Cholestatic Pruritus in PBC

Andreas Kremer, MD, PhD, MHBA - Initiating the Conversation on Itch: Modelling Best Practices in Patient-Centred Care for Cholestatic Pruritus in PBC

Andreas Kremer, MD, PhD, MHBA - Initiating the Conversation on Itch: Modelling Best Practices in Patient-Centred Care for Cholestatic Pruritus in PBC

Andreas Kremer, MD, PhD, MHBA - Initiating the Conversation on Itch: Modelling Best Practices in Patient-Centred Care for Cholestatic Pruritus in PBC

The Filtrate:Joel TopfSwapnil HiremathSophia AmbrusoAC GomezJosh WaitzmanJennie LinNayan AroraThe CurbsidersMatt F. Watto (@DoctorWatto)Paul Nelson Williams, America's primary care physician (@PaulNWilliamz)With Special Guest:JD Foster (@KidneyVet)Sayed Tabatabai (@TheRealDoctorT) Nephrologist in Austin and the author of These Vital SignsMichelle Rheault (@rheault_m) Chief of Pediatric Nephrology at the University of Minnesota and lead author of the DUPLEX TrialEditor:Joel TopfShow Notes:Lily toxicity in the cat (PubMed)Surgeons perform kidney transplants in cats amid rising demand for advanced pet care (ABC News)Treatment of ibuprofen toxicity with serial charcoal hemoperfusion and hemodialysis in a dog (PubMed)Nephrology in Veterinary Medicine (Kidney 360)Star Wars Society of San Antonio (FaceBook)These Vital Signs (Amazon)Dr Tabatabai read a short story called The Handholder, here is the original tweet thread for that story (ThreadReader)The pearl not the patient (PubMed)Late Braking and High Impact Clinical Trial press releaseMENTOR, Rituximab or Cyclosporine in the Treatment of Membranous Nephropathy, was in 2019 not 2017 (NEJM)KALM-1, A Phase 3 Trial of Difelikefalin in Hemodialysis Patients with Pruritus, was in 2019 not 2017 (NEJM)Sophie's number one pick: Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial (Lancet)Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6–110) was −2·7 mL/min per 1·73 m2 per year versus −3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1–week 110) was −2·9 mL/min per 1·73 m2 per year versus −3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI −0·03 to 1·94; p=0·058).Clinical Trial Considerations in Developing Treatments for Early Stages of Common, Chronic Kidney Diseases: A Scientific Workshop Cosponsored by the National Kidney Foundation and the US Food and Drug Administration (AJKD)AC Gomez's Pick: MDR-101-MLK Update: Operational Immune Tolerance Achieved in Living Related HLA-Matched Kidney Transplant Recipients (ASN-Online.org) Josh's Pick: A Phase 2 Trial of Sibeprenlimab in Patients with IgA Nephropathy (NEJM)Nayan's Pick: The EnAKT LKD Cluster Randomized Clinical Trial (JAMA Internal Medicine) The Freely Filtered simultaneous release (NephJC)Freely Filtered is now a verb. Swap's Pick: Strategies for the Management of Atrial Fibrillation in PatiEnts Receiving Dialysis (SAFE-D) (ASN-Online.org)Joel's Pick: AYAME Study: Randomized, Double-Blind, Placebo-Controlled Phase 3 Study of Bardoxolone Methyl in Diabetic Kidney Disease (DKD) Patients (ASN-Online.org)Reata is a no-show to the 2012 ASN Kidney Week (PBFluids)Michelle's Pick: Sparsentan versus Irbesartan in Focal Segmental Glomerulosclerosis. The DUPLEX Study (NEJM)DUET: A Phase 2 Study Evaluating the Efficacy and Safety of Sparsentan in Patients with FSGS (PubMed)

People who have kidney disease often complain about itching. This can be a medical condition called Pruritus. Some people have a such a severe itch that it keeps them up at night. If this sounds like you or someone you love, listen in to this show to hear Nephrology Nurse Practitioner Kristin Larson MSN, RN, AGNP-BC, CNN talk about what might be causing it what treatments exist to get some relief.

Cat head and neck pruritus... what differentials for you have for a feline friend that is showing this pattern? Check out this week's episode of The Derm Vet podcast!Reference from the episode: Hobi S, et al. Clinical characteristics and causes of pruritus in cats: a multicenter study on feline hypersensitivity-associated dermatoses. Vet Dermatol 2011; 22: 406-413.

The Michael Anthony Show returns for Episode 161.Tune in.Support the show

Dr. Kendra Wulczyn discusses the results of her study "Incidence and Risk Factors for Pruritus in Patients with Nondialysis CKD," on behalf of her colleagues.

This educational activity will meet nephrology nurses where they are and provide them with expert insights into CKD-aP prevalence, patient burden, therapeutic rationale, and pivotal principles for safely and effectively integrating novel treatments into practice. The role of the nurse as a premier patient-facing care provider will be emphasized throughout, and notable focus will be placed on CKD-aP symptom recognition, patient education, drug administration, and toxicity management.Collect credit: https://www.ceconcepts.com/ckd-ch-podcast

In this podcast, Laura Swoboda, DNP, APNP, FNP-C, FNP-BC, CWOCN-AP, discusses wound pruritus and how it is a common complication in burn healing. Pruritus can significantly impact the quality of life, interrupt sleep, and cause skin injury leading to further complications including wounds and cellulitis.

Be a part of this team as they consider the cause of itching and choose a treatment approach for a patient on dialysis. Credit available for this activity expires: 10/11/2023 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/982017?src=mkm_podcast_addon_982017

Christopher Posner Chief Executive Officer, President, and Director Mr. Posner has served as our President and Chief Executive Officer since November 2021 and has served as a member of our Board since August 2018. He has broad experience in commercial and marketing operations and product management at both large and specialty pharmaceutical companies, where he has focused on products for autoimmune, inflammatory and pain conditions, including Xeljanz® and Enbrel®. From July 2017 to October 2021, he served as the Chief Executive Officer of LEO Pharma, Inc. US, a subsidiary of LEO Pharma A/S, a global healthcare company specializing in dermatology and critical care, including such conditions as psoriasis and atopic dermatitis. Prior to joining LEO, he was the Head of Worldwide Commercial Operations at R-Pharma-US, LLC, a specialty pharmaceutical company focused on oncology and chronic immune disorders, from 2014 until 2017. Previously, Mr. Posner held a variety of senior management positions in commercial and marketing operations at Bristol-Myers Squibb Company, Pfizer Inc., Wyeth Pharmaceuticals, Inc. and Endo Pharmaceuticals plc. Mr. Posner holds an M.B.A. from Fuqua School of Business, Duke University and a B.A. in Economics from Villanova University. Please see korsuva.com/pi for Full Prescribing Information.

As a dermatology specialists we tend to see the more severe, chronic cases of allergic dermatitis and infection. But in general practice, our colleagues are seeing these cases at much earlier stage in younger dogs. So how do you start management at these initial signs of allergies?This podcast episode welcomes back Dr. Dana Liska, DACVD. Dr. Liska is a senior veterinary dermatologist with Zoetis. We discuss early recognition, management and client communication regarding canine allergic dermatitis.This podcast is sponsored by Zoetis.

Would you like to learn about managing chronic kidney disease-associated pruritus in dialysis patients? Join us here! Credit available for this activity expires: 8/18/2023 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/979339?src=mkm_podcast_addon_979339

On July 7, Intercept Pharmaceuticals released new results from the continuation of the REGENERATE trial and announced their intent to file a new NDA for obeticholic acid (OCA) in NASH fibrosis. In this conversation, Stephen Harrison leads Jörn Schattenberg, Louise Campbell and Roger Green in considering less obvious questions surrounding efficacy and safety.Stephen starts this conversation by asking the group how important it is for a drug (in this case, obeticholic acid) to show a combined endpoint of fibrosis improvement and NASH resolution. He notes this is a tougher standard to hit but notes that it might be quite important.Jörn describes this comment as a "good point" that probably was not addressed due to the low level of NASH resolution when viewed as a primary endpoint. Louise says she would need to know more about the diets patients were on while in the trial given the effect diet can have on liver fat. She then goes on to say that one question she would like to have answered is how many patients needed counseling on their pruritus to stay in the study and what exact steps did researchers take to keep these patients in. She points out that knowing the steps necessary to maintain patient adherence is vitally important to caregivers but rarely reported for trials, if ever.Roger makes two points. His first basically supports Jörn's comment that the low level of NASH resolution as a primary endpoint virtually guarantees that the number of patients achieving the dual endpoint will be minimal at best. His second harkens back to Stephen's earlier point about including a larger post-18 month patient pool in the efficacy analysis. To Roger, it appears that Intercept made the sound commercial decision to reveal only the data necessary to generate the analyses necessary for approval. It felt to him as if Intercept assessed the least risky way to refute each point in the CRL, and then did only the analyses necessary to refute points successfully. In essence, Roger describes the analysis as a way to de-risk the drug and believes they appear to have done so effectively. At this point, Stephen shifts direction. He gives Intercept "accolades...they didn't give up. They persevered. They continued to drive forward and they added three different adjudication committees." And while he believes there is more analysis to be done, he describes the contents of the press release as "a very, very positive implication for the field" and "give[s] it two thumbs up." After Roger concurs, Stephen goes back to Louise's questions about pruritus and notes that the methodology for evaluating pruritus might have produced overstated results. In essence, the investigator asked patients whether they were experiencing pruritus at every visit, an approach Stephen and Jörn believe was likely to produce an overstatement on itching. Stephen continues this line of thinking to note that investigators were forced to discontinue therapy under certain pruritus reports. As the conversation ends, he notes that he is far more interested in hepatic effects.

On July 7, Intercept Pharmaceuticals released new results from the continuation of the REGENERATE trial and announced their intent to file a new NDA for obeticholic acid (OCA) in NASH fibrosis. In this conversation, Stephen Harrison leads Jörn Schattenberg, Louise Campbell and Roger Green in considering whether the evidence in the new release will be sufficient to get the drug approved.Stephen starts by noting that we have not heard anything about the results of the REVERSE trial, which evaluated obeticholic acid (OCA) in patients with compensated cirrhosis. As he notes, even if OCA is not approved for cirrhosis, many hepatologists will consider giving this drug to cirrhotic patients, particularly compensated cirrhotics who face a significant worsening of their condition in a fairly short period of time. Jörn comments on this briefly to agree that the cirrhosis data will create a complete data set, then returns to the pruritus issue. Mostly, his point about cirrhosis is that given the high placebo rate suggests there is "something about how the question is asked." He finishes this comment by discussing the importance of getting a first drug approved and stating his anticipation of what happens when FDA reviews these data. Roger goes on to note that he has a unique experience in this group: he has discontinued a drug therapy based on pruritus (in his case, a cancer drug). Having lived through that experience, he expresses skepticism that pruritus that resolves on discontinuation will be a reason for the drug to be rejected. Stephen concurs, and Roger goes on to state that the perceived cardiovascular risk in 2020 made sense as a reason not to approve, but not pruritus. Stephen and Louise concur that we will not know the entire story until we know the lengths to which providers went to keep patients in this study, but both are hopeful (and pretty much expect) that while there may be boundaries on patient types and guidance on treatment, the case for approval appears likely to succeed. During the second half of this conversation, panelists share their common hope that this data will be sufficient to get OCA approved and discuss what this could mean for the entire Fatty Liver stakeholder community.

The post Itching for Answers: A Practical Approach to Managing Pruritus in Atopic Dermatitis and Beyond appeared first on JDDonline - Journal of Drugs in Dermatology.

Itch is... uncomfortable. We've all been there before, one motivated mosquito takes a bite out of you, and you are left with an itchy red spot for a few days that only scratching can temporarily relieve. Have you ever wondered how that sensation is transferred to the brain and processed? How about why pain, like pressing really hard on that mosquito bite makes the itching go away. If the answer to any of these questions is YES, come and take a listen to learn a little bit more about what's happening upstairs!Please rate, review, and subscribe and if you have any questions, comments, concerns, queries, or complaints, please email me at neuroscienceamateurhour@gmail.com or DM me at NeuroscienceAmateurHour on Instagram.Citations and relevant pictures are below:Henley C. Touch: The Skin. openbookslibmsuedu. Published online January 1, 2021. https://openbooks.lib.msu.edu/neuroscience/chapter/touch-the-skin/#:~:text=with%20the%20skin.-‌Feher J. 4.3 - Cutaneous Sensory Systems. ScienceDirect. Published January 1, 2012. Accessed March 13, 2022. https://www.sciencedirect.com/science/article/pii/B9780128008836000355Ringkamp M, Meyer R. Pruriceptors. PubMed. Published 2014. Accessed March 13, 2022. https://www.ncbi.nlm.nih.gov/books/NBK200917/Schmelz M. Itch Processing in the Skin. Frontiers in Medicine. 2019;6. doi:10.3389/fmed.2019.00167Ikoma A, Cevikbas F, Kempkes C, Steinhoff M. Anatomy and Neurophysiology of Pruritus. Seminars in cutaneous medicine and surgery. 2011;30(2):64-70. doi:10.1016/j.sder.2011.04.001Potenzieri C, Undem BJ. Basic mechanisms of itch. Clinical & Experimental Allergy. 2011;42(1):8-19. doi:10.1111/1. Shim W-S, Oh U. Histamine-Induced Itch and its Relationship with Pain. Molecular Pain. 2008;4:1744-80694-29. doi:10.1186/1744-8069-4-29j.1365-2222.2011.03791.xForster C, Handwerker HO. Central Nervous Processing of Itch and Pain. PubMed. Published 2014. https://www.ncbi.nlm.nih.gov/books/NBK200926/Papoiu ADP, Coghill RC, Kraft RA, Wang H, Yosipovitch G. A Tale of Two Itches. Common Features and Notable Differences in Brain Activation Evoked by Cowhage And Histamine Induced Itch. Neuroimage. 2012;59(4):3611-3623. doi:10.1016/j.neuroimage.2011.10.099Ishiuji Y. Addiction and the itch‐scratch cycle. What do they have in common? Experimental Dermatology. 2019;28(12):1448-1454. doi:10.1111/exd.14029Support the show (https://www.patreon.com/neuroscienceamateurhour)

In this podcast, Laura Swoboda, DNP, APNP, FNP-C, FNP-BC, CWOCN-AP, discusses wound pruritus and how it is a common complication in burn healing. Pruritus can significantly impact the quality of life, interrupt sleep, and cause skin injury leading to further complications including wounds and cellulitis.