Treatment of pruritus due to hepatobiliary diseases (HBP), represents a clinical challenge for a high number of patients: up to 70-80% of hepatobiliary disease patients are affected with untreatable HBP with deleterious consequences in quality of life, daily activities and sleep disturbances, often refractory to pharmacological pruritus treatment. Such hyperresponsiveness is explained by its physiopathology: Despite advances in identifying potential causative agents, such as bile salts and neurotransmitters, a comprehensive understanding and effective treatment of pruritus in cholestasis remain elusive.