Fujino H, Tanaka M, Imamura M, et al. - In patients with chronic liver disease from a large cohort, researchers examined frequency, severity and predictive factors of pruritus [defined as an unpleasant sensation that triggers the need to scratch], as well as explored the connection between serum autotaxin levels and liver fibrosis and pruritus in primary biliary cholangitis (PBC) patients. In total, 2,477 individuals with chronic liver disease without allergies or skin diseases were examined for itch frequency and severity. Using the numerical rating scale (NRS), itch severity has been self-assessed using pruritus scores. According to multivariate analysis, lower albumin, higher eosinophil count, and etiology of PBC were identified as independent factors linked to severe pruritus (≥ 5 points of NRS). In patients with chronic liver disease, the frequency of pruritus was high. Based on the large number of patients with chronic liver disease, reduction of liver function was related to severe pruritus. Serum autotaxin is useful for evaluating liver fibrosis and cholangitis severity, however, in patients with PBC, it is not a predictive marker for severe pruritus.