Corticosteroid Therapy in Severe Alcoholic Hepatitis

Porter, Henrik P.; Simon, F. R.; Pope, C. E.; Volwiler, Wade; Fenster, Laura

doi:10.1056/nejm197106172842404

Cited by 153 publications

(32 citation statements)

References 19 publications

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“…However, until the Maddrey function became available, no reproducible objective criterion existed to predict the risk of early death. Indeed, prior to the era of the discriminant function (DF), survival in untreated control arms ranged from 0 to 81% in previous randomized controlled trials evaluating treatment in patients with AH [4,5,[19][20][21][22][23][24][25][26][27][28][29]. Maddrey et al described a DF [19] and later modified it [5] into its more widely used form.…”

Section: The Effect Of Treatment On Survival Can Be Observed Only In mentioning

confidence: 99%

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Corticosteroids for alcoholic hepatitis—what's next?

Mathurin

2005

Journal of Hepatology

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Section: The Effect Of Treatment On Survival Can Be Observed Only In mentioning

confidence: 99%

“…Thirteen randomized control trials evaluated corticosteroids in patients with AH [4,5,[19][20][21][22][23][24][25][26][27][28][29]. These trials yielded inconsistent results.…”

Section: We Need To Look Beyond the Controversy Of Corticosteroidsmentioning

confidence: 99%

Corticosteroids for alcoholic hepatitis—what's next?

Mathurin

2005

Journal of Hepatology

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“…Alcoholic hepatitis and/or cirrhosis occur in approximately 15-20% of those who abuse alcohol over a prolonged period of time with different threshold for men and women [1,2]. Once developed, AH has mortality exceeding fifty percent in some series [3]. Alcohol abstinence and correcting nutritional deficiencies have been the main treatment options.…”

Section: Introductionmentioning

confidence: 99%

MELD score is a better prognostic model than Child-Turcotte-Pugh score or Discriminant Function score in patients with alcoholic hepatitis

Srikureja¹,

Kyulo²,

Runyon³

et al. 2005

Journal of Hepatology

208

150

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“…Therefore, there is an urgent need to provide these patients with novel targeted therapies. In the last two decades, there have been several attempts to test old and novel drugs in patients with severe AH, ranging from classic drugs [8] to monoclonal antibodies [9] or stimulating factors [10] to bone marrow transplantation [11]. While some of them have improved short-term mortality, the results have not yet been confirmed in independent cohorts.…”

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confidence: 99%

Alcoholic hepatitis: should we combine old drugs for better results?

Cabezas

Bataller

2016

Hepatol Int

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Alcoholic liver disease (ALD) is the main cause of cirrhosis worldwide [1]. Despite its high prevalence, ALD has received little attention in the liver community and there is a clear lack of programs for early detection and novel targeted therapies for advanced forms. ALD encloses a wide spectrum of features, ranging from simple steatosis, steatohepatitis, and cirrhosis to hepatocellular carcinoma [2]. Patients with underlying ALD and heavy alcohol intake can develop an episode of alcoholic hepatitis (AH), the most severe form of ALD [3]. AH is characterized by an abrupt onset of jaundice and/or liver decompensation. Patients with AH often show signs of systemic inflammation at admission, and are prone to infections and kidney injury, which can lead to multi-organ dysfunction within a few days [4]. In its severe form, AH can result in 20-50 % mortality at 3 months. The only available therapies that improve survival are corticosteroids and liver transplantation [5,6]. The efficacy of pentoxifylline is debatable, based on recent large clinical trials [6]. The efficacy of prednisolone has been shown in meta-analyses of individual data and was partially confirmed in the recent STOPAH trial [6,7]. Unfortunately, many patients do not respond to prednisolone and performing salvage liver transplantation is not feasible in most centers. Therefore, there is an urgent need to provide these patients with novel targeted therapies. In the last two decades, there have been several attempts to test old and novel drugs in patients with severe AH, ranging from classic drugs [8] to monoclonal antibodies [9] or stimulating factors [10]

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Corticosteroid Therapy in Severe Alcoholic Hepatitis

Cited by 153 publications

References 19 publications

Corticosteroids for alcoholic hepatitis—what's next?

Corticosteroids for alcoholic hepatitis—what's next?

MELD score is a better prognostic model than Child-Turcotte-Pugh score or Discriminant Function score in patients with alcoholic hepatitis

Alcoholic hepatitis: should we combine old drugs for better results?

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