Treatment of pruritus in cholestasis of pregnancy with a new anion exchange resin (Secholex).

Anion exchange resins form a non-absorbable complex with bile acids in the intestine, thus removing bile acids from the enterohepatic circulation and facilitating bile acid excretion in the faeces. A new bile acid sequestrant (PDX chloride, Secholex) was evaluated for the relief of pruritus in cholestasis of pregnancy (CP) in 31 women. CP was verified by the presence of the abnormal lipoprotein X in serum and the clinical series was divided into two degrees of severity, pruritus gravidarum (PG) and hepatosis of pregnancy (HP) based on liver function tests. Eleven of 31 women discontinued treatment because of gastro-intestinal side effects. Of the 20 women continuing the study for more than one week, all with a milder form of cholestasis, PG (n=8), experienced relief of pruritus, while some relief was obtained in 75% of the women with HP. After up to 4 weeks administration of Secholex, no obvious interference with fat absorption was evident judging from the serum lecithin content of linoleic and arachidonic acids. A reduction in serum folic acid might indicate an interaction in folic acid absorption. An expected reduction in serum cholesterol levels which are characteristically increased in CP, was not achieved by the administration of Secholex.