Foc5-3histological Parameters Define Long-Term Prognosis in Asymptomatic Alcoholic Liver Disease

Lackner, C.; Spindelboeck, Walter; Haybaeck, Johannes; Douschan, Philipp; Rainer, Florian; Haas, Josef; Stauber, R.E.

doi:10.1093/alcalc/agv079.17

Cited by 4 publications

(6 citation statements)

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“…In a more recent cohort of patients with biopsy-proven ALD, those with fully compensated liver disease who achieved abstinence showed a survival benefit (log rank p = 0.017) compared with those who continued to drink. 30 However, most of these patients had cirrhosis (40 out of 60 patients), and multivariate Cox analysis showed only fibrosis stage as a significant predictor of outcome leaving uncertainty over the role of alcohol in non-fibrotic ALD. A meta-analysis of histological progression of ALD found insufficient available data to analyze the effect of alcohol consumption on disease progression.…”

Section: Alcohol Consumption In Early Diseasementioning

confidence: 96%

“…Patients with decompensated, biopsy-proven liver disease had markedly improved survival for those who abstained from alcohol after the initial diagnosis compared with those who continued to drink (log rank, p = 0.013). 30 However, in a meta-analysis of patients with biopsy-proven disease, although a difference in mortality rate was seen between patients with cirrhosis who were abstinent or not (median annual mortality was 4.7% [IQR: 4–7%] vs. 8.0% [IQR: 6.2–11.2%] in abstinent patients and in non-abstinent patients, respectively), this was not statistically significant (Mann–Whitney test, p = 0.229). 29 A study of biopsy-proven disease published since this meta-analysis included 630 French patients with ALD cirrhosis.…”

Section: Alcohol Consumption In Advanced Diseasementioning

confidence: 99%

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Alcohol-Related Liver Disease: Is There a Safe Alcohol Consumption Limit for Liver Disease?

Pekarska,

Parker

2023

Semin Liver Dis

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This review is to evaluate how much alcohol is safe in the context of alcohol-related liver disease (ALD). In patients without an established diagnosis of ALD consuming alcohol at quantities below 12 to 20 g daily with alcohol-free days is associated with a very low risk of developing disease. This risk is mediated by the presence of cofactors such as sex, medical comorbidity, obesity, and genetic factors. A threshold effect below which liver disease will not occur is not seen, instead a dose–response relationship where risk ranges from low to high. Once ALD is present, natural history studies confirm that continued alcohol consumption is clearly associated with an increased risk of ill health and premature death. In conclusion, low-level alcohol consumption in the absence of liver disease is associated with a very small risk of developing ALD, but once ALD is present patients should be supported to achieve complete abstinence from alcohol.

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Section: Alcohol Consumption In Early Diseasementioning

confidence: 96%

Section: Alcohol Consumption In Advanced Diseasementioning

confidence: 99%

Alcohol-Related Liver Disease: Is There a Safe Alcohol Consumption Limit for Liver Disease?

Pekarska,

Parker

2023

Semin Liver Dis

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“…Alcohol consumption is the most important factor in promoting the progression of fibrosis in alcohol-associated cirrhosis with a major impact on 10-year mortality. 41 Although it is well-known that alcohol consumption is the strongest factor influencing mortality and poor patient-related outcomes in the cirrhotic population, how alcohol triggers decompensation(s) is not fully understood. From a histological standpoint, patients who achieve a prolonged period of abstinence have no or mild steatosis, and minor parenchymal lymphomonocytic infiltrate, if any, compared with those individuals who continue to drink alcohol.…”

Section: Alcohol Limit On Patients With Compensated Advanced Chronic ...mentioning

confidence: 99%

“…Although complete alcohol abstinence remains the cornerstone of the management of ALD, it is only achieved by around a third of patients. 41 45 Additionally, there are scarce data regarding the effect of low- versus high-dose alcohol or complete abstinence. However, several clinical studies have proven that persistent alcohol consumption is an independent predictor of mortality.…”

Section: Alcohol Limit On Patients With Compensated Advanced Chronic ...mentioning

confidence: 99%

Is There a Safe Alcohol Consumption Limit for the General Population and in Patients with Liver Disease?

Romero-Gómez,

Arab,

Oliveira

et al. 2024

Semin Liver Dis

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Excessive alcohol consumption represents an important burden for health systems worldwide and is a major cause of liver- and cancer-related deaths. Alcohol consumption is mostly assessed by self-report that often underestimates the amount of drinking. While alcohol use disorders identification test - version C is the most widely used test for alcohol use screening, in patients with liver disease the use of alcohol biomarker could help an objective assessment. The amount of alcohol that leads to significant liver disease depends on gender, genetic background, and coexistence of comorbidities (i.e., metabolic syndrome factors). All patients with alcohol-associated liver disease are recommended to follow complete abstinence and they should be treated within multidisciplinary teams. Abstinence slows down and even reverses the progression of liver fibrosis and can help recompensate patients with complicated cirrhosis. Whether there is a safe amount of alcohol in the general population is a matter of intense debate. Large epidemiological studies showed that the safe amount of alcohol to avoid overall health-related risks is lower than expected even in the general population. Even one drink per day can increase cancer-related death. In patients with any kind of chronic liver disease, especially in those with metabolic-associated steatotic liver disease, no alcohol intake is recommended. This review article discusses the current evidence supporting the deleterious effects of small-to-moderate amounts of alcohol in the general population and in patients with underlying chronic liver disease.

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“…Abstinence can reverse the progression of early ALD to more advanced disease. 20 21 22 23 Among those with advanced disease, AUD treatment reduces liver disease severity, decompensation, readmission to the hospital, and consequently improve patient survival. For example, in a study on Veterans with AC, AUD treatment was associated with reduction in decompensation and mortality at 6 months from index diagnosis compared with those who did not receive AUD treatment.…”

Section: Treatment Of Alcohol Use Disordermentioning

confidence: 99%

Therapeutic Pipeline in Alcohol-Associated Liver Disease

2022

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Alcohol-associated liver disease is a leading cause of mortality and morbidity worldwide. Patients with alcohol-associated liver disease are often diagnosed at advanced stage and disease spectrum including alcoholic hepatitis, a severe manifestation with a high short-term mortality. Corticosteroid, recommended first-line treatment for patients with alcoholic hepatitis, is a very suboptimal treatment. Although the use of early liver transplantation has increased with consistent benefit in select patients with alcoholic hepatitis, its use remains heterogeneous worldwide due to lack of uniform selection criteria. Over the last decade, several therapeutic targets have evolved of promise with ongoing clinical trials in patients with cirrhosis and alcoholic hepatitis. Even with availability of effective medical therapies for alcohol-associated liver disease, long-term outcome depends on abstinence from alcohol use in any spectrum of alcohol-associated liver disease. However, alcohol use disorder treatment remains underutilized due to several barriers even in patients with advanced disease. There is an urgent unmet need to implement and promote integrated multidisciplinary care model with hepatologists and addiction experts to provide comprehensive management for these patients. In this review, we will discuss newer therapies targeting liver disease and therapies targeting alcohol use disorder in patients with alcohol-associated liver disease.

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Foc5-3histological Parameters Define Long-Term Prognosis in Asymptomatic Alcoholic Liver Disease

Cited by 4 publications

References 0 publications

Alcohol-Related Liver Disease: Is There a Safe Alcohol Consumption Limit for Liver Disease?

Alcohol-Related Liver Disease: Is There a Safe Alcohol Consumption Limit for Liver Disease?

Is There a Safe Alcohol Consumption Limit for the General Population and in Patients with Liver Disease?

Therapeutic Pipeline in Alcohol-Associated Liver Disease

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