Navigating the management of cholestatic pruritus in patients with PBC: Insights from the multidisciplinary team

Expert Spotlight

Prof. Gideon Hirschfield

University of Toronto, Toronto, Canada

Prof. Sonja Ständer

University of Münster, Münster, Germany

Mrs Collette Thain

PBC Foundation, Edinburgh, UK

Prof. Gideon Hirschfield, Prof. Sonja Ständer and Mrs Collette Thain discuss the impact of living with cholestatic pruritus for patients with PBC.

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Tutorial

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Poll

What disease burden is most common in your patients with cholestatic pruritus & PBC?

Cognitive impairment

Fatigue

Feelings of shame

Other

Submit your answer to see the results

Cognitive impairment

Fatigue

Feelings of shame

Other

Hepatologist, dermatologist and patient advocate

Get the Audio Version

Pruritus in PBC and me: The patient experience

Time: 11:19

Prof. Hirschfield, Prof. Ständer, Mrs Thain

Watch a hepatologist, a dermatologist and a patient advocate discuss the manifestations of cholestatic pruritus in patients with PBC, the impact of the condition on quality of life and the importance of individualizing treatment goals.

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Nurse, dermatologist and hepatologist

Symptom assessment and monitoring in clinical practice

Watch Now

Expert Spotlight

Ms Michelle Clayton

St James’ University Hospital, Leeds, UK

Prof. Sonja Ständer

University of Münster, Münster, Germany

Prof. Gideon Hirschfield

University of Toronto, Toronto, Canada

Ms Michelle Clayton, Prof. Sonja Ständer and Prof. Gideon Hirschfield discuss symptom assessment and monitoring for cholestatic pruritus in patients with PBC.

Get the Audio Version

Tutorial

These icons indicate there is something to be interacted with. Click it when you see it.

Poll

What tool do you use most often to assess the burden of cholestatic pruritus in PBC?

NRS

PBC-40

PGI-S or -C

Another tool

Submit your answer to see the results

NRS

PBC-40

PGI-S or -C

Another tool

Nurse, dermatologist and hepatologist

Get the Audio Version

Symptom assessment and monitoring in clinical practice

Time: 13:13

Ms Clayton, Prof. Ständer, Prof. Hirschfield

Watch a nurse, a dermatologist and a hepatologist discuss the importance of assessing for cholestatic pruritus in patients with PBC and review the tools used in clinical practice.

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Dermatologist, nurse, hepatologist and patient advocate

A comprehensive approach to symptom care in PBC

Watch Now

Expert Spotlight

Prof. Sonja Ständer

University of Münster, Münster, Germany

Ms Michelle Clayton

St James’ University Hospital, Leeds, UK

Prof. Gideon Hirschfield

University of Toronto, Toronto, Canada

Mrs Collette Thain

PBC Foundation, Edinburgh, UK

Prof. Sonja Ständer, Ms Michelle Clayton, Prof. Gideon Hirschfield and Mrs Collette Thain discuss individualizing treatment strategies for patients with PBC and cholestatic pruritus, and the importance of a comprehensive and collaborative approach to care.

Get the Audio Version

Tutorial

These icons indicate there is something to be interacted with. Click it when you see it.

Poll

How frequently do you discuss patient advocacy group support with your patients?

At every appointment

At some appointments, if necessary

Only when asked about patient support groups

Never

Submit your answer to see the results

At every appointment

At some appointments, if necessary

Only when asked about patient support groups

Never

Dermatologist, nurse, hepatologist and patient advocate

Get the Audio Version

A comprehensive approach to symptom care in PBC

Time: 13:28

Prof. Ständer, Ms Clayton, Prof. Hirschfield, Mrs Thain

Watch a dermatologist, a nurse, a hepatologist and a patient advocate discuss individualizing management strategies for patients with cholestatic pruritus and PBC, and the importance of patient education and counselling.

Watch Next

Hepatologist, dermatologist and patient advocate

Pruritus in PBC and me: The patient experience

Watch Now

Overview & Learning Objectives

Overview

In this activity, a multidisciplinary team including a hepatologist, a dermatologist and a nurse share their perspectives on the assessment and management of cholestatic pruritus in patients with PBC. Plus, a patient advocate shares their insights on the impact of living with cholestatic pruritus on quality of life.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

Dermatologists, gastroenterologists, hepatologists and nurse practitioners involved in the management of cholestatic pruritus in patients with PBC.

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Prof. Gideon Hirschfield discloses: Consultancy fees from Advanz Pharma, CymaBay, Dr. Falk Pharma, Escient Pharmaceuticals, Gilead, GSK, Intercept, Ipsen, Mirum and Pliant Therapeutics.

Prof. Sonja Ständer discloses: Advisory board or panel fees from AbbVie, Galderma, Lilly, Pfizer and Sanofi. Consultancy fees from AbbVie, Clexio, Galderma, Incyte, Lilly, Pfizer and Sanofi. Grants/research support from German Research Foundation, Novartis, Sanofi and Trevi Therapeutics. Speaker’s bureau fees from AbbVie, BMS, Eli Lilly, Galderma, Novartis, Pfizer, Sanofi and UCB.

Ms Michelle Clayton discloses: Advisory board or panel fees from Norgine. Other financial or material support (royalties, patent, etc.) from Dr. Falk Pharma.

Mrs Collette Thain has no interests/relationships or affiliations to disclose in relation to this activity.

Content reviewer

Danielle Walker, DNP, APRN, AGNP-C has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Contributors

Katrina Lester has no financial interests/relationships or affiliations in relation to this activity.

Joanne Morton has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu.

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credit^TM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 Credit^TM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

EBAC^® Accreditation

touchIME is an EBAC^® accredited provider since 2023.

This programme is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC^®) for 0.75 hours of effective education time.

The Accreditation Council for Continuing Medical Education (ACCME^®), and the Royal College of Physicians and Surgeons of Canada hold an agreement on mutual recognition on substantive equivalency of accreditation systems with EBAC^®.

Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals and the American Medical Association (AMA), physicians may convert EBAC^® CE credits to AMA PRA Category 1 Credits^TM. Information on the process to convert EBAC^® credit to AMA credit can be found on the AMA website. Other healthcare professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 Credit^TM.

Faculty Disclosure Statement / Conflict of Interest Policy

In compliance with EBAC^® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event have been mitigated and declared to the audience prior to the CME activities.

Requirements for Successful Completion

Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC^® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC^® CE credit certificate. EBAC^® grants 1 CE credit for every hour of education completed.

Date of original release: 26 September 2024. Date credits expire: 26 September 2025.

Time to complete: 48 minutes

If you have any questions regarding credit please contact cpdsupport@usf.edu.

If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org.

Learning Objectives

After watching this activity, participants should be better able to:

Describe the burden of cholestatic pruritus in patients with PBC and the lack of awareness of addressing symptom control
Assess and monitor symptoms of cholestatic pruritus, and use individualized treatment strategies to improve outcomes in affected patients
Apply a comprehensive approach to patient management, involving patient education and counselling

Faculty & Disclosures

Prof. Gideon Hirschfield

University of Toronto, Toronto, Canada

Prof. Gideon Hirschfield is the Lily and Terry Horner Chair in Autoimmune Liver Disease Research at the Toronto Centre for Liver Disease. He directs the Autoimmune Liver Disease team at the University Health Network and is the clinic director of the Francis Family Liver Clinic. read more

Prof. Hirschfield is a full Professor at the University of Toronto, and was previously a full Professor at the University of Birmingham in the UK. He did his undergraduate training at Oxford and Cambridge Universities, and his PhD was awarded by the University of London.

Prof. Hirschfield is a physician scientist with a focus on autoimmune and rare liver diseases. His clinical work aligns with his academic programme and is exclusive to people living with primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis, as well as a variety of rare liver diseases, pre- and post-liver transplant. Aligned with this clinical work, Prof. Hirschfield is involved in a range of translational research/trial programmes focused on improving patient quality and duration of life, as well as in training national and international clinical fellows in autoimmune liver disease care.

Prof. Gideon Hirschfield discloses: Consultancy fees from Advanz Pharma, CymaBay, Dr. Falk Pharma, Escient Pharmaceuticals, Gilead, GSK, Intercept, Ipsen, Mirum and Pliant Therapeutics.

Prof. Sonja Ständer

University of Münster, Münster, Germany

Prof. Sonja Ständer is a professor of dermatology and neurodermatology at the University of Münster and the head of the Interdisciplinary Center for Chronic Pruritus (KCP) at the University Hospital Münster in Germany. read more

In 2001, she received her board certification in dermatology, allergology and phlebology. In 2006, she became board certified in dermatopathology after training in Münster and at the Ackermann Academy in New York, USA. In 2008, she established the Center for Chronic Pruritus at the University Hospital Münster and has been the head of this interdisciplinary centre since then. In addition, she played a leading role in the foundation of the first international and national societies for itch. She chairs the European Academy of Dermatology and Venereology Pruritus Task Force, is an author of national and European guidelines for chronic pruritus and chairs psychometric committees (special interest group of the International Forum for the Study of Itch and the itch group of the International Dermatology Outcome Measures).

In 2011, Prof. Ständer obtained the title of professor of dermatology (W3) from the University of Münster and dedicated herself to translational neurodermatology and pruritus research, becoming the worldwide leader in this field. In 2015, Prof. Ständer was awarded a Doctor Honoris Causa title for her research efforts from the University of Wrocław in Poland.

Ms Michelle Clayton

St James’ University Hospital, Leeds, UK

Michelle Clayton is a Liver Nurse Educator at St James’ University Hospital in Leeds and, until recently, was involved in nurse education at the University of Leeds, UK. Michelle has over 30 years of experience in the field of hepatology and liver transplantation. read more

Ms Clayton is passionate about championing quality care for people with liver disease. In April 2019, she became the first elected chairperson for the British Liver Nurses’ Association (BLNA), serving the liver nurse community in the UK. She was also the first chair of the European Association for the Study of the Liver Nurses and Allied Health Professionals taskforce, raising the profile of liver nursing across Europe, until June 2021. Michelle is on the editorial board of Gastrointestinal Nursing and was integral in developing the journal’s Liver Nursing supplement.

Ms Clayton has a large portfolio of publications and speaks both nationally and internationally on a range of care considerations for people with liver disease and liver transplantation. In 2012, she won the Gastrointestinal Nursing Educationist of the Year award for her work in advancing liver nurse education and care, and in 2013 she led and successfully launched the ‘Caring for People with Liver Disease: A Competence Framework for Nursing’. On behalf of the Royal College of Nursing, Ms Clayton worked with the BLNA and British Liver Transplant Group to produce a new competence framework, launched in September 2019, to include caring for people following liver transplantation .

Ms Michelle Clayton discloses: Advisory board or panel fees from Norgine. Other financial or material support (royalties, patent, etc.) from Dr. Falk Pharma.

Mrs Collette Thain MBE

PBC Foundation, Edinburgh, UK

Collette Thain was diagnosed with primary biliary cholangitis (PBC) in 1994 at the age of 37, having suffered from symptoms since she was 17 years old. read more

Her diagnosis came as a huge shock to the young mother, who was told her disease was incurable and progressive, and the only hope was a liver transplant. Worse to come was the realization that there was no information readily available (not even a leaflet), nor support of any kind, which added to Collette’s feelings of fear and isolation.

Collette, with the help of her hepatologist, managed to obtain help and support from the seven PBC specialist centres within the UK. Through fundraising efforts, support from family and friends and a huge amount of hard work, Collette founded the PBC Foundation in 1996 with the aim of supplying much needed and valuable information to people with PBC wherever it was needed.

Thirty years later, the PBC Foundation is the biggest organization of its kind in the world providing help, support and information to people with PBC and their families in more than 80 countries.

Mrs Collette Thain has no interests/relationships or affiliations to disclose in relation to this activity.

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CE/CME Test (0.75 Points)

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Patient with cholestatic pruritus and PBC

Pruritus in PBC and me: The patient experience

Symptom assessment and monitoring in clinical practice

A comprehensive approach to symptom care in PBC

Expert Spotlight

Prof. Gideon Hirschfield

Prof. Sonja Ständer

Mrs Collette Thain

Tutorial

Poll

Hepatologist, dermatologist and patient advocate

Watch Next

Nurse, dermatologist and hepatologist

Expert Spotlight

Ms Michelle Clayton

Prof. Sonja Ständer

Prof. Gideon Hirschfield

Tutorial

Poll

Nurse, dermatologist and hepatologist

Watch Next

Dermatologist, nurse, hepatologist and patient advocate

Expert Spotlight

Prof. Sonja Ständer

Ms Michelle Clayton

Prof. Gideon Hirschfield

Mrs Collette Thain

Tutorial

Poll

Dermatologist, nurse, hepatologist and patient advocate

Watch Next

Hepatologist, dermatologist and patient advocate

Overview & Learning Objectives

Overview

Learning Objectives

Faculty & Disclosures

Prof. Gideon Hirschfield

Prof. Sonja Ständer

Ms Michelle Clayton

Mrs Collette Thain MBE

Downloads

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CE/CME Test

Which of the following represents a burden associated with cholestatic pruritus in patients with PBC?PBC, primary biliary cholangitis.

Which of the following PRO tools would you use to numerically rate the intensity of itching in patients with cholestatic pruritus and PBC?EQ-5D, EuroQoL-5D; NRS, numerical rating scale; PBC, primary biliary cholangitis; PRO, patient-reported outcome; SF-36, 36-Item Short Form Health Survey.

Assuming local availability and based on guideline recommendations, which of the following treatments would you recommend for patients with PBC and cholestatic pruritus? IL, interleukin; PBC, primary biliary cholangitis; SNRI, serotonin and norepinephrine reuptake inhibitor.

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This Functionality is forMembers Only

Which of the following represents a burden associated with cholestatic pruritus in patients with PBC?

PBC, primary biliary cholangitis.

Which of the following PRO tools would you use to numerically rate the intensity of itching in patients with cholestatic pruritus and PBC?

EQ-5D, EuroQoL-5D; NRS, numerical rating scale; PBC, primary biliary cholangitis; PRO, patient-reported outcome; SF-36, 36-Item Short Form Health Survey.

Assuming local availability and based on guideline recommendations, which of the following treatments would you recommend for patients with PBC and cholestatic pruritus?

IL, interleukin; PBC, primary biliary cholangitis; SNRI, serotonin and norepinephrine reuptake inhibitor.

This Functionality is for
Members Only