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Sertraline as an Additional Treatment for Cholestatic Pruritus in Children

Alice Thébaut1, Dalila Habes, Frédéric Gottrand

  • 1*Pediatric Hepatology and Liver Transplantation Unit, Hôpital Bicêtre, Reference Centre for Pediatric Liver Diseases-DHU Hepatinov, Assistance Publique-Hôpitaux de Paris, Université Paris Sud, Le Kremlin-Bicêtre †INSERM UMR-S 1174, University Paris-Sud, Orsay ‡Pediatric Gastroenterology and Hepatology Department, CHU-Lille, Univ Lille, Lille §Pediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron ||Pediatric Hepatology Unit, Hôpital Necker-Enfants-Malades, Paris, France.

Journal of Pediatric Gastroenterology and Nutrition
|August 25, 2016
PubMed

Insights

Sertraline shows promise in treating severe itching in children with chronic cholestasis. This study found that sertraline improved pruritus, skin scratching, and sleep in most pediatric patients with refractory cholestatic pruritus.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Clinical Pharmacology

Background:

  • Chronic cholestasis often causes severe, debilitating pruritus in children.
  • Current first-line treatments like ursodeoxycholic acid and rifampicin may be insufficient for refractory cases.
  • Serotonin reuptake inhibitors (SRIs) show potential for managing cholestatic pruritus based on adult studies.

Purpose of the Study:

  • To evaluate the efficacy and safety of sertraline, an SRI, for treating refractory cholestatic pruritus in pediatric patients.
  • To assess the impact of sertraline on pruritus severity, skin-induced damage, and sleep disturbances in children.

Main Methods:

  • A prospective, multicenter study included 20 children with refractory cholestatic pruritus.
  • Sertraline was administered at a median daily dose of 2.2 mg/kg, adjusted individually.
  • Pruritus, skin scratching, and sleep impairment were assessed using validated scores before and after 3 months of treatment.

Main Results:

  • Pruritus improved in 14 out of 20 children after 3 months of sertraline therapy.
  • The median itching score significantly decreased from 8/10 to 5/10.
  • Improvements in skin scratching and sleep quality were observed in 9 of the 14 responding patients.

Conclusions:

  • Sertraline may be a beneficial therapeutic option for managing refractory cholestatic pruritus in children.
  • The drug demonstrated a favorable safety profile with manageable adverse events.
  • Further research is warranted to confirm these findings in larger pediatric cohorts.
Abstract

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