Preliminary Observations of &lt;i&gt;d&lt;/i&gt;-Penicillamine Therapy in Acute Alcoholic Liver Disease

Resnick, Robert H.; Boitnott, J. K.; Iber, F. L.; Makopour, H.; Cerda, J.J.

doi:10.1159/000197590

Cited by 38 publications

(3 citation statements)

References 10 publications

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“…In 62 patients with AH randomized to amlodipine or placebo in a double-blind, controlled trial, the putative hepatoprotective effect of calcium-channel blockers did not improve clinical outcomes [23]. Antifibrotics such as colchicines [24], penicillamine [25], and anticatabolic agents such as propylthiouracil have shown no benefit [26].…”

Section: Anti-tnf-α Monoclonalsmentioning

confidence: 97%

Alcoholic Hepatitis

Agarwal

Kontorinis

Dieterich

2004

Curr Treat Options Gastro

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Alcoholic hepatitis (AH) is a common disease associated with significant morbidity and mortality. Most often the diagnosis is suggested by a history of heavy alcohol excess in a patient with features of hepatic decompensation. In its purest form, AH is a histologic diagnosis of acute hepatic inflammation in response to alcohol. The primary objective of treatment for AH is to support long-term alcohol abstinence and to achieve adequate nutrition with lifestyle modification; goal setting and education are integral to long-term medical management. Severity at presentation (calculated by way of the Maddrey score) determines outcome. Patients with AH represent a heterogeneous group with regard to severity and pathogenesis, with various therapeutic interventions assessed in patients with severe AH. To date, corticosteroids have been studied most, and despite remaining controversial, warrant a place in the treatment of selected patients. Recent advances in unraveling the aspects of disease pathogenesis in AH have raised the possibility of targeted therapies, such as anti-tumor necrosis factor-a monoclonals and pentoxifylline. Orthotopic liver transplantation is not recommended for patients with severe acute AH, as most have an unclear long-term prognosis in the context of ongoing excess alcohol ingestion at presentation.

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Section: Anti-tnf-α Monoclonalsmentioning

confidence: 97%

Alcoholic Hepatitis

Agarwal

Kontorinis

Dieterich

2004

Curr Treat Options Gastro

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“…Unlike other causes of liver failure, liver transplantation is not considered an option for these patients [2]. Most treatment modalities that have been studied in clinical trials in AAH have disappointed, including colchicine, propylthiouracil, insulin and glucagon, anabolic steroids, and penicillamine [3][4][5][6][7]. Pentoxifylline, an inhibitor of TNF-a production, was associated with a significant short-term survival advantage in one study [8].…”

Section: Introductionmentioning

confidence: 99%

Antioxidants versus corticosteroids in the treatment of severe alcoholic hepatitis—A randomised clinical trial

Phillips

Curtis

Portmann

et al. 2006

Journal of Hepatology

183

106

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“…In a small study, Resnick et al [40] showed a reduction in hepatocellular necrosis and active deposition of collagen in the liver. Larger studies are needed to assess the effectiveness of this drug.…”

Section: Emerging Therapiesmentioning

confidence: 97%

Alcoholic liver disease

Abittan

Lieber

1999

Curr Treat Options Gastro

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The traditional approach to alcoholism is treatment of underlying psychological and behavioral problems. Earlier and more direct avenues to prevent or counteract alcohol's effects include a focus on early detection of alcoholism, using, in part, biochemical markers of heavy drinking such as carbohydrate-deficient transferrin (CDT) and screening, among heavy users of alcohol, for signs of medical complications. Only a few heavy drinkers eventually develop liver cirrhosis. Because no practical genetic markers exist indicating who will develop fibrosis and cirrhosis, heavy drinkers who have signs of liver injury should undergo liver biopsy to determine whether they have perivenular fibrosis, a recognized precursor lesion to cirrhosis. Those who do should start intense treatment efforts, such as correction of nutritional deficits, curbing alcohol consumption, and participation in ongoing controlled trials. Some "supernutrients" have been effective in baboons, including S-adenosylmethionine for the treatment of alcohol-induced liver injury and polyenylphosphatidylcholine for the prevention of fibrosis. Both drugs are now being tested in humans. Prednisolone improves survival in patients with alcoholic hepatitis who have either spontaneous hepatic encephalopathy or a high "discriminant function."

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Preliminary Observations of <i>d</i>-Penicillamine Therapy in Acute Alcoholic Liver Disease

Cited by 38 publications

References 10 publications

Alcoholic Hepatitis

Alcoholic Hepatitis

Antioxidants versus corticosteroids in the treatment of severe alcoholic hepatitis—A randomised clinical trial

Alcoholic liver disease

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