Royeck Svenja, Mess Christian, Weigel Angelika, Löwe Bernd, Toussaint Anne, Schramm Christoph, Shedden Mora Meike, Huber Tobias B, Zeidler Claudia, Witte Felix, Augustin Matthias, Agelopoulos Konstantin, Wiegmann Henning, Oehm Johannes B, Schneider Stefan W, Ständer Sonja
Pruritus Medicine Section, Department of Dermatology and Center for Chronic Pruritus (KCP), University Hospital Münster, Münster, Germany.
Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Dermatol Ther (Heidelb). 2025 Sep 11. doi: 10.1007/s13555-025-01539-3.
Chronic pruritus (CP; lasting ≥ 6 weeks) is a prevalent symptom with diverse underlying conditions, including chronic liver diseases (CLD), chronic kidney diseases (CKD) and atopic dermatitis (AD). CP is linked to a substantial physical, psychological and socioeconomic burden. Despite guideline-recommend therapies, there remains a lack of comprehensive understanding regarding the specific needs, treatment goals and patient-reported outcomes (PRO) of patients with CP across these aetiologies.
To address this gap, this retrospective cohort study analysed anonymized electronic health records from a specialized pruritus centre in Germany, focusing on three matched sub-cohorts, which were compiled from a total cohort of 1998 patients with CLD, CKD and AD to systematically compare disease burden, and treatment priorities.
Patients with CLD and CKD exhibited significantly higher psychological distress compared to patients with AD, while patients with AD demonstrated greater quality of life impairment. Treatment goals were largely aligned across all patient groups, with symptom relief, diagnostic clarity and confidence in therapy emerging as top priorities. Significant correlations between patient needs, QoL impairment, levels of anxiety and depression and pruritus intensity were observed across all sub-cohorts.
These results highlight the need for holistic, patient-centred management strategies that address both the physical and psychological aspects of CP.
慢性瘙痒（持续时间≥6周）是一种普遍存在的症状，其潜在病因多种多样，包括慢性肝病（CLD）、慢性肾病（CKD）和特应性皮炎（AD）。慢性瘙痒与巨大的身体、心理和社会经济负担相关。尽管有指南推荐的治疗方法，但对于这些病因导致的慢性瘙痒患者的具体需求、治疗目标和患者报告结局（PRO）仍缺乏全面的了解。
为了填补这一空白，这项回顾性队列研究分析了德国一家专门的瘙痒症中心的匿名电子健康记录，重点关注三个匹配的亚队列，这些亚队列是从总共1998例慢性肝病、慢性肾病和特应性皮炎患者的队列中选取的，以系统地比较疾病负担和治疗优先级。
与特应性皮炎患者相比，慢性肝病和慢性肾病患者表现出明显更高的心理困扰，而特应性皮炎患者的生活质量受损更大。所有患者组的治疗目标基本一致，症状缓解、诊断明确和对治疗的信心成为首要任务。在所有亚队列中，均观察到患者需求、生活质量受损、焦虑和抑郁水平与瘙痒强度之间存在显著相关性。
这些结果凸显了需要采取以患者为中心的整体管理策略，以解决慢性瘙痒的身体和心理方面问题。
