Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study

Bjõrnsson, Einar; Hauksson, Kristján; Sigurdardóttir, Ragna; Arnardottir, Margret; Ágústsson, Arnar S; Lund, Sigrún H.; Kalaitzakis, Evangelos

doi:10.1080/00365521.2020.1743751

Cited by 4 publications

(12 citation statements)

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“…ARLD caused by long-term heavy drinking included the whole disease spectrum from liver steatosis to liver cirrhosis and even liver cancer [ 237 ]. The constituent ratio of alcoholic cirrhosis in ARLD population was the highest, up to 32.9% (95% CI: 27.3–38.7) (Table 2 ) got from 147 articles [ 16 , 19 , 25 – 27 , 31 , 36 , 46 , 64 , 66 , 80 , 81 , 84 , 86 , 91 , 92 , 98 , 100 – 102 , 111 , 113 , 117 , 119 , 121 – 124 , 145 , 148 , 149 , 152 , 153 , 157 , 159 – 162 , 165 , 170 , 173 – 176 , 187 , 193 , 194 , 197 , 199 , 208 , 219 , 221 – 223 , 225 , 227 , 229 – 234 , 236 , 238 – 321 ]. A total of 121 datasets [ 25 , 26 , 30 , 43 , 47 , 113 , 115 , 116 , 122 , 125 , 126 ...…”

Section: Resultsmentioning

confidence: 99%

“…A total of 114 datasets [ 17 , 23 , 25 , 26 , 30 , 33 , 36 , 39 , 43 , 46 , 64 , 115 , 126 , 128 , 130 , 136 , 140 , 142 , 156 , 162 , 168 , 169 , 173 , 176 , 186 , 189 , 190 , 192 , 196 , 197 , 204 , 208 , 213 , 216 , 220 , 223 , 225 , 228 , 231 , 236 , 242 – 245 , 249 , 258 , 265 , 267 , 273 , 276 , 280 , 283 , 294 , 307 , 309 , 311 , 320 – 322 , 324 – 329 , 332 – 336 , 338 – 345 , 347 , 348 , 353 , 355 , 356 , 359 , 364 ,…”

Section: Resultsunclassified

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Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis

Niu

Zhu

et al. 2023

BMC Public Health

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Background Alcohol related liver disease (ARLD) is one of the major chronic liver diseases worldwide. This review aimed to describe the global prevalence, incidence, and outcomes of ARLD. Methods Medline, Embase, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched from inception to May 31, 2022. The language was restricted to English or Chinese. According to the criteria, articles describing the basic characteristics of the population were selected. Two reviewers extracted the data independently. Results A total of 372 studies were identified: 353 were used for prevalence analysis, 7 were used for incidence analysis, and 114 were used to for outcome analysis. The prevalence of ARLD worldwide was 4.8%. The prevalence in males was 2.9%, which was higher than female (0.5%). Among the ethnic groups, the percentage was highest in Caucasians (68.9%). Alcoholic liver cirrhosis comprised the highest proportion in the disease spectrum of ARLD at 32.9%. The prevalence of ascites in ARLD population was highest (25.1%). The ARLD population who drinking for > 20 years accounted for 54.8%, and the average daily alcohol intake was 146.6 g/d. About 59.5% of ARLD patients were current or former smokers, and 18.7% were complicated with hepatitis virus infection. The incidence was 0.208/1000 person-years. The overall mortality was 23.9%, and the liver-related mortality was 21.6%. Conclusion The global prevalence of ARLD was 4.8% and was affected by sex, region, drinking years, and other factors. Therefore, removing the factors causing a high disease prevalence is an urgent requisite. Trial registration PROSPERO Nr: CRD42021286192

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Section: Resultsmentioning

confidence: 99%

Section: Resultsunclassified

Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis

Niu

Zhu

et al. 2023

BMC Public Health

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“…The first is that attendance at psychological treatment and rehabilitation may be a marker of more severe dependency and thus predicts future alcohol use. This observation is reported in three of the studies included in this review 35,39,41 . Second, in the case of patients with cirrhosis, it could be that patients with advanced disease become too unwell to either consume alcohol or engage with alcohol therapies.…”

Section: Discussionmentioning

confidence: 87%

“…An additional two records were added after reviewing the reference lists of relevant review articles. One hundred and forty‐six articles were reviewed in full text and 23 studies were eligible for inclusion in the review 16,29–50 (Figure 1). One study reported on two distinct cohorts 42 (a retrospective cohort with prospective validation) which were treated as separate populations.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review: Interventions for alcohol use disorder in patients with cirrhosis or alcohol‐associated hepatitis

Oldroyd,

Greenham,

Martin

et al. 2023

Aliment Pharmacol Ther

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SummaryBackgroundAlcohol use is the most important factor in determining the prognosis of patients with alcohol‐related cirrhosis and alcohol‐associated hepatitis.AimTo conduct a systematic review of interventions for alcohol use disorder specific to patients with cirrhosis or alcohol‐associated hepatitis.MethodsWe searched five databases between inception and November 2022. The primary outcomes were abstinence, hepatic decompensation and mortality. We included randomised and non‐randomised studies. Risk of bias was assessed using validated tools. Where possible, meta‐analysis was performed.ResultsTwenty‐three studies met the inclusion criteria including six randomised trials and 17 non‐randomised studies of interventions. These included 104,298 patients with a mean/median age range from 44 to 65, of whom 75% were male. Interventions included psychological therapy, pharmacological therapies, specialist clinics, patient education and low alcohol drinks. Baclofen was the only intervention to demonstrate a statistically significant impact on the primary outcomes in a randomised trial (abstinence OR: 6.3, 95% CI: 2.4–16.1). Three non‐randomised studies reported reductions in episodes of hepatic decompensation that were significant in multivariate models. This was in response to psychological therapy, use of any pharmacotherapy, and use of any treatment. A meta‐analysis of non‐randomised studies that examined the impact of psychological therapies revealed statistically non‐significant improvements in abstinence (4 studies, OR: 1.87, 95% CI: 0.38–9.23) and mortality (4 studies, OR: 0.47, 95% CI: 0.12–1.77).ConclusionsBaclofen is the only intervention with randomised trial evidence for significant benefit in patients with cirrhosis. Non‐randomised studies also point to non‐pharmaceutical interventions possibly improving clinical outcomes.

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Prognostic Factors in Alcohol-associated Liver Disease Patients Presenting With First Evidence of Ascites

Fahoum

Shen²,

Basu

et al. 2023

Journal of Clinical Gastroenterology

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Goals:To identify factors associated with transplantation and death in alcohol-associated liver disease (ALD) patients presenting with first evidence of ascites.Background: Ascites development is a poor prognostic sign for patients with cirrhosis. Among ALD patients, the baseline factors at time of ascites development that are associated with eventual transplantation or death are currently unknown.Study: Adult patients with ascites in the "Evaluating Alcohol Use in Alcohol-related Liver Disease Prospective Cohort Study" (NCT03267069 clinicaltrials.gov) were identified from 2016 to 2020. Demographic, clinical, and laboratory factors at initial ascites presentation were identified as potential predictors of transplant and death as competing risks.Results: A total of 96 patients were identified. Median (interquartile range) follow-up time was 2.00 years (0.87 to 3.85). By last followup, 34/96 patients had been transplanted (35.4%) and 11/96 had died (11.4%). Prognostic factors for transplant included age per decade [hazard ratio (HR): 0.52 (95% CI, 0.33 to 0.83)], employed status [HR: 0.35 (95% CI, 0.14 to 0.90)], and sodium [HR: 0.94 (95% CI, 0.90 to 0.99)], whereas prognostic factors for death were body mass index [HR: 1.11 (95% CI, 1.00 to 1.22)], Charlson index [HR: 2.14 [95% CI, 1.13 to 4.08]), Maddrey Discriminant Function > 32 (HR: 5.88 (95% CI, 1.18, 29.39)], aspartate aminotransferase [HR: 0.99 (95% CI, 0.98 to 0.997)], and a prior 12-month abstinence period [HR: 5.53 (95% CI, 1.10 to 27.83)], adjusted for age, sex, and ALD subcategory.Conclusions: Several factors at initial ascites presentation are associated with increased risk of transplantation or death and validation in larger cohorts will allow for improved risk stratification for ALD patients.

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Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study

Cited by 4 publications

References 21 publications

Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis

Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis

Systematic review: Interventions for alcohol use disorder in patients with cirrhosis or alcohol‐associated hepatitis

Prognostic Factors in Alcohol-associated Liver Disease Patients Presenting With First Evidence of Ascites

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