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Prednisolone or Pentoxifylline for Alcoholic Hepatitis

by Vergis, Nikhil , Patch, David , O’Grady, John , Hood, Steven , Ryder, Stephen , Richardson, Paul , Allison, Michael , Ratcliffe, Ian , Wright, Mark , Downs, Nichola , Austin, Andrew , MacGilchrist, Alastair , Forrest, Ewan H , Roderick, Paul , Masson, Steven , Day, Christopher P , Gleeson, Dermot , McCune, Anne , Mellor, Jane , Thursz, Mark R , Grant, Allister , Bowers, Megan , Stanton, Louise

in Adult / Alcohol use / Analysis of Variance / Clinical trials / Double-Blind Method / Drug therapy / Female / Glucocorticoids - adverse effects / Glucocorticoids - therapeutic use / Hepatitis / Hepatitis, Alcoholic - drug therapy / Hepatitis, Alcoholic - mortality / Humans / Infections - etiology / Jaundice / Kaplan-Meier Estimate / Liver transplantation / Male / Middle Aged / Mortality / Patients / Pentoxifylline - adverse effects / Pentoxifylline - therapeutic use / Phosphodiesterase Inhibitors - adverse effects / Phosphodiesterase Inhibitors - therapeutic use / Prednisolone / Prednisolone - adverse effects / Prednisolone - therapeutic use / Steroids / Treatment Failure

2015

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2015

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2015

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Journal Article

Prednisolone or Pentoxifylline for Alcoholic Hepatitis

Vergis, Nikhil,

Patch, David,

O’Grady, John,

Hood, Steven,

Ryder, Stephen,

Richardson, Paul,

Allison, Michael,

Ratcliffe, Ian,

Wright, Mark,

Downs, Nichola,

Austin, Andrew,

MacGilchrist, Alastair,

Forrest, Ewan H,

Roderick, Paul,

Masson, Steven,

Day, Christopher P,

Gleeson, Dermot,

McCune, Anne,

Mellor, Jane,

Thursz, Mark R,

Grant, Allister,

Bowers, Megan,

Stanton, Louise

2015

Overview

In this randomized trial in patients hospitalized with alcoholic hepatitis, pentoxifylline did not improve survival. The 28-day survival advantage in patients treated with prednisolone did not reach significance and was not sustained at 90 days or 1 year. Alcoholic hepatitis is a distinct manifestation of alcoholic liver disease that is characterized by jaundice and liver failure. This condition develops in persons with a history of prolonged and heavy alcohol use. 1 The severity of alcoholic hepatitis is conventionally defined by Maddrey’s discriminant function, which is calculated as 4.6×(patient’s prothrombin time in seconds−control’s prothrombin time in seconds)+patient’s serum bilirubin level in milligrams per deciliter; a value of 32 or higher indicates severe alcoholic hepatitis that carries an adverse prognosis, with mortality of 20 to 30% within 1 month after presentation and 30 to 40% within 6 months after presentation. 2 A . . .

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Publisher

Massachusetts Medical Society

Subject

Adult

/ Alcohol use

/ Analysis of Variance

/ Clinical trials

/ Double-Blind Method

/ Drug therapy

/ Female