Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 01 June 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Prednisolone with vs without pentoxifylline in severe alcoholic hepatitis

This week's issue of the Journal of the American Medical Association compares prednisolone with vs without pentoxifylline and survival of patients with severe alcoholic hepatitis.

News image

Prednisolone or pentoxifylline is recommended for severe alcoholic hepatitis, a life-threatening disease.

The benefit of their combination is unknown.

Dr Philippe Mathurin and colleagues from France determined whether the addition of pentoxifylline to prednisolone is more effective than prednisolone alone.

The team performed a multicenter, randomized, double-blind clinical trial conducted between 2007 and 2010 in 1 Belgian and 23 French hospitals of 270 patients aged 18 to 70 years.

The patients were heavy drinkers with severe biopsy-proven alcoholic hepatitis, as indicated by recent onset of jaundice in the prior 3 months and a Maddrey score of at least 32. Duration of follow-up was 6 months.

The last included patient completed the study in 2010.

None of the patients were lost to follow-up for the main outcome.

The Model for End-Stage Liver Disease score was independently associated with 6-month survival
Journal of the American Medical Association

Patients were randomly assigned to receive either a combination of 40 mg of prednisolone once a day and 400 mg of pentoxifylline 3 times a day for 28 days, or 40 mg of prednisolone and matching placebo for 28 days.

The team's main outcomes and measures included 6-month survival, with secondary end points of development of hepatorenal syndrome and response to therapy based on the Lille model, which defines treatment nonresponders after 7 days of initiation of treatment.

In intention-to-treat analysis, 6-month survival was not different in the pentoxifylline-prednisolone and placebo-prednisolone groups, corresponding to 40 vs 42 deaths, respectively.

In multivariable analysis, only the Lille model and the Model for End-Stage Liver Disease score were independently associated with 6-month survival.

The team found that at 7 days, response to therapy assessed by the Lille model was not significantly different between the 2 groups.

The researchers observed that the probability of being a responder was not different in both groups.

The cumulative incidence of hepatorenal syndrome at 6 months was not significantly different in the pentoxifylline-prednisolone, and the placebo-prednisolone groups.

Dr Mathurin's team concludes, "In patients with alcoholic hepatitis, 4-week treatment with pentoxifylline and prednisolone, compared with prednisolone alone, did not result in improved 6-month survival."

"The study may have been underpowered to detect a significant difference in incidence of hepatorenal syndrome, which was less frequent in the group receiving pentoxifylline."

JAMA 2013: 310(10)
12 September 2013

Go to top of page Email this page Email this page to a colleague

 01 June 2016 
Predicting NASH resolution
 01 June 2016 
Treatment of Hep C/HIV after liver transplant
 01 June 2016 
Predicting relapse in IBD
 31 May 2016 
Markers as a reflection of inflammatory burden in ulcerative colitis
 31 May 2016 
Predicting Crohn's diseases before diagnosis
 31 May 2016 
Biomarker predicts post ERCP pancreatitis
 30 May 2016 
Challenges for direct-acting antivirals in Hep C
 30 May 2016 
Endoscopic indices for disease activity in ulcerative colitis
 30 May 2016 
Colonoscopy reimbursement reduction in practice
 27 May 2016 
Obstructive sleep apnea and NASH
 27 May 2016 
Risk stratification in acute upper GI bleeding
 27 May 2016 
Hepatocellular carcinoma in chronic Hep B patients
 26 May 2016 
Education booklet for colonoscopy bowel preparation
 26 May 2016 
Direct-acting antivirals in Hep C cirrhosis
 26 May 2016 
Uncomplicated diverticulitis in outpatients
 25 May 2016 
PPIs and NSAID-induced small bowel injury
 25 May 2016 
Preventing NSAID-associated GI toxicity
 25 May 2016 
Recurrence of Barrett’s after successful endoscopic therapy
 24 May 2016 
New therapies for NASH
 24 May 2016 
Fecal inflammatory markers in Crohn's
 24 May 2016 
Depression and IBD recurrence
 23 May 2016 
Cancer after colectomy in IBD
 23 May 2016 
Risk factors for peptic ulcer bleeding outcomes
 23 May 2016 
Liver transplantation for hepatocellular carcinoma
 20 May 2016 
Prognostic score for hepatic venous outflow obstruction
 20 May 2016 
Treatment for uncomplicated acute diverticulitis
 20 May 2016 
Biomarker for colorectal cancer diagnosis
 19 May 2016 
Probiotics and H. pylori eradication
 19 May 2016 
Impaired skeletal health in atrophic gastritis
 19 May 2016 
Predicting outcome in ulcerative colitis
 18 May 2016 
Erectile dysfunction in IBD
 18 May 2016 
Acute GERD and esophageal histologic changes
 18 May 2016 
Surgical fundoplication for GERD 
 17 May 2016 
Mucosal dysbiosis in Crohn's disease
 17 May 2016 
Vitamin D level and clinical status in IBD 
 17 May 2016 
Inpatient costs for IBD and acute pancreatitis
 16 May 2016 
Outcomes of postcolonoscopy colorectal cancers
 16 May 2016 
Therapy for Crohn's in a Medicaid population
 16 May 2016 
C. difficile in ulcerative colitis patients
 13 May 2016 
Parkinson's disease and IBD
 13 May 2016 
Inactivated oral cholera vaccine
 13 May 2016 
Non-traditional heart disease risk factors in NAFLD
 12 May 2016 
Gestational diabetes mellitus and NAFLD
 12 May 2016 
Impact of Crohn's in the USA
 12 May 2016 
Ozanimod induction and ulcerative colitis
 11 May 2016 
Anti-TNF discontinuation in IBD
 11 May 2016 
Age and disease presentation with Crohn's disease
 11 May 2016 
Prognosis after colorectal cancer resection
 10 May 2016 
Gluten-free diet in patients with IBS-diarrhea
 10 May 2016 
Noninvasive test for IBD
 10 May 2016 
Digital health for gastroenterology
 09 May 2016 
Diarrheal infections in adults
 09 May 2016 
Quality improvement initiative and readmission for cirrhosis
 09 May 2016 
Coffee or tea and the risk of Barrett's
 06 May 2016 
Risk factors in peptic ulcer bleeding
 06 May 2016 
Recurrent pancreatitis after acute pancreatitis
 06 May 2016 
Managing acute lower GI bleeding
 05 May 2016 
Chemoradiotherapy vs chemotherapy for pancreatic cancer
 05 May 2016 
Genetics in early-early-onset IBD
 05 May 2016 
Reductions in quality of screening colonoscopies

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us