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Pruritus, or itching, is a common and persistent symptom in patients with primary sclerosing cholangitis (PSC), affecting about 25% of patients at moderate to severe intensity. The intensity of itching is positively associated with markers of advanced liver disease, including cirrhosis and elevated serum bile markers. This symptom substantially reduces health-related quality of life (HRQoL). Notably, pruritus intensity remains stable over time in a majority of affected patients, although spontaneous improvements occur in some cases, suggesting variable natural history and the need for targeted therapy.
