VIDEO: ‘Clear correlation’ between IL-31, pruritus in primary biliary cholangitis
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In a Healio video exclusive, Andreas Kremer, MD, PhD, MHBA, highlights recent data on primary biliary cholangitis presented at EASL Congress, including risk factors for disease progression and seladelpar for treatment of pruritus.
In a retrospective analysis, Kremer and colleagues examined 1,111 patients with primary biliary cholangitis (PBC) who received ursodeoxycholic acid as first-line treatment. Overall, 26% of patients screen-failed due to elevated alkaline phosphatase levels.
“Patients with an alkaline phosphatase level above upper limit of normal but below 1.67 of normal are at risk for disease progression,” Kremer, deputy head of the hepatology department at University Hospital Zürich, said. “It’s worthwhile investigating this subgroup in dedicated randomized controlled trials.”
Other noninvasive parameters indicative of screen failure were enhanced liver fibrosis score and liver stiffness values, he noted.
Kremer also discussed results from the phase 3 ENHANCE study, which assessed use of seladelpar, a selective PPAR-delta agonist, for the treatment of pruritus among 161 patients with PBC. Seladelpar dose-dependently decreased interleukin-31 levels, which correlated with pruritus improvement and changes in total bile acids.
“So far, we have not understood the full pathophysiology of pruritus in liver disease and, in particular, there is so far no good explanation how PPAR-agonists could result in improved itch sensation,” Kremer said. “Here, we could now clearly show that IL-31, despite the fact that the levels are much lower compared to those dermatologic diseases, there is a clear correlation with itch intensity and treatment response and thus we suggest that IL-31 could have a key role in modulating pruritus in patients with PBC.”
References:
- Kremer A, et al. Poster 2489: Baseline characteristics and risk profiles of 1,111 patients with primary biliary cholangitis (PBC) in need of second-line therapy. Presented at: EASL Congress; June 21-24, 2023; Vienna (hybrid meeting).
- Kremer A, et al. Poster: Seladelpar treatment resulted in correlated decreases in serum IL-31 and pruritus in patients with primary biliary cholangitis (PBC): Post-hoc results from the phase 3 randomized, placebo-controlled ENHANCE study. Presented at: EASL Congress; June 21-24, 2023; Vienna (hybrid meeting).
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