Polycythemia vera manifests as a myeloproliferative neoplasm associated with diverse symptoms, including aquagenic pruritis. This systematic review addresses the pressing need to enhance the understanding of the dise...Polycythemia vera manifests as a myeloproliferative neoplasm associated with diverse symptoms, including aquagenic pruritis. This systematic review addresses the pressing need to enhance the understanding of the disease’s symptomatology and optimize treatment strategies for improved patient outcomes. The rarity and low prevalence of polycythemia vera underscore the importance of this investigation, as existing standard of care involves a multifaceted approach and significant healthcare costs. Despite advancement in therapeutic options, persistent symptoms and resistance to first-line treatments pose challenges. Ruxolitinib has emerged as a promising intervention, demonstrating clinically significant improvement for patients. This systematic review appraises three randomized controlled trials, shedding light on the efficacy of ruxolitinib and its potential to ameliorate pruritis symptoms in symptomatic patients.展开更多
To review the underlying pathophysiology and currently available treatments for pruritis associated with jaundice.English language literature was reviewed using MEDLINE,Pub Med,EMBASE and clinicaltrials.gov for papers...To review the underlying pathophysiology and currently available treatments for pruritis associated with jaundice.English language literature was reviewed using MEDLINE,Pub Med,EMBASE and clinicaltrials.gov for papers and trails addressing the pathophysiology and potential treatments for pruritis associated with jaundice.Recent advances in the understanding of the peripheral anatomy of itch transmission have defined a histamine stimulated pathway and a cowhage stimulated pathway with sensation conveyed centrally via the contralateral spinothalamic tract.Centrally,cowhage andhistamine stimulated neurons terminate widely within the thalamus and sensorimotor cortex.The causative factors for itch in jaundice have not been clarified although endogenous opioids,serotonin,steroid and lysophosphatidic acid all play a role.Current guidelines for the treatment of itching in jaundice recommend initial management with biliary drainage where possible and medical management with ursodeoxycholic acid,followed by cholestyramine,rifampicin,naltrexone and sertraline.Other than biliary drainage no single treatment has proved universally effective.Pruritis associated with jaundice is a common but poorly understood condition for which biliary drainage is the most effective therapy.Pharmacological therapy has advanced but remains variably effective.展开更多
文摘Polycythemia vera manifests as a myeloproliferative neoplasm associated with diverse symptoms, including aquagenic pruritis. This systematic review addresses the pressing need to enhance the understanding of the disease’s symptomatology and optimize treatment strategies for improved patient outcomes. The rarity and low prevalence of polycythemia vera underscore the importance of this investigation, as existing standard of care involves a multifaceted approach and significant healthcare costs. Despite advancement in therapeutic options, persistent symptoms and resistance to first-line treatments pose challenges. Ruxolitinib has emerged as a promising intervention, demonstrating clinically significant improvement for patients. This systematic review appraises three randomized controlled trials, shedding light on the efficacy of ruxolitinib and its potential to ameliorate pruritis symptoms in symptomatic patients.
文摘To review the underlying pathophysiology and currently available treatments for pruritis associated with jaundice.English language literature was reviewed using MEDLINE,Pub Med,EMBASE and clinicaltrials.gov for papers and trails addressing the pathophysiology and potential treatments for pruritis associated with jaundice.Recent advances in the understanding of the peripheral anatomy of itch transmission have defined a histamine stimulated pathway and a cowhage stimulated pathway with sensation conveyed centrally via the contralateral spinothalamic tract.Centrally,cowhage andhistamine stimulated neurons terminate widely within the thalamus and sensorimotor cortex.The causative factors for itch in jaundice have not been clarified although endogenous opioids,serotonin,steroid and lysophosphatidic acid all play a role.Current guidelines for the treatment of itching in jaundice recommend initial management with biliary drainage where possible and medical management with ursodeoxycholic acid,followed by cholestyramine,rifampicin,naltrexone and sertraline.Other than biliary drainage no single treatment has proved universally effective.Pruritis associated with jaundice is a common but poorly understood condition for which biliary drainage is the most effective therapy.Pharmacological therapy has advanced but remains variably effective.
