Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton 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 September 2014

Advanced search
 01 September 2014 
Fecal hemoglobin and colorectal cancer screening
 01 September 2014 
Genetic variants in alcoholic liver disease
 01 September 2014 
Risks with anti-TNF in pediatric IBD
 29 August 2014 
NSAID-induced small intestinal injury and diaphragm disease
 29 August 2014 
Symptom evaluation in functional dyspepsia
 29 August 2014 
Gluten-free diet for asymptomatic celiac disease
 28 August 2014 
Predictoris of C. diff in out-patients
 28 August 2014 
Detection of gastroesophageal reflux symptoms
 28 August 2014 
Colorectal-cancer mortality after adenoma removal
 27 August 2014 
Endoscopy outcomes in community hospital vs tertiary academic centers
 27 August 2014 
UV exposure and IBD hospitalizations
 27 August 2014 
Hepatocellular carcinoma screening in liver disease
 26 August 2014 
NAFLD and gastroesophageal reflux symptoms
 26 August 2014 
Adalimumab-treated patients with ulcerative colitis
 26 August 2014 
Wound healing after abdominoperineal resection
 25 August 2014 
Surgical management of rectourethral fistulas
 25 August 2014 
Biomarker analysis in biopsies for ulcerative colitis
 25 August 2014 
Ileocolic resection in Crohn's disease
 22 August 2014 
Outlier identification in colorectal surgery
 22 August 2014 
Endoscopic submucosal dissection for squamous esophageal cancer
 22 August 2014 
Adherence to Rome criteria in functional dyspepsia trials
 21 August 2014 
Screening for Barrett’s esophagus
 21 August 2014 
Colorectal cancer mortality in Brazil
 21 August 2014 
Eosinophilic esophagitis
 20 August 2014 
Rectal surgery mortality
 20 August 2014 
Chemotherapy-induced gastrointestinal mucositis
 20 August 2014 
Stool methylated DNA markers and colorectal cancer resection
 19 August 2014 
Recurrent C. difficile infection in out-patients
 19 August 2014 
Racial disparities and colon cancer
 19 August 2014 
Variability of colonoscopy preparation instructions
 18 August 2014 
The evolution of urban C. difficile
 18 August 2014 
Metabolomic analysis in IBD
 18 August 2014 
Enhanced T-cell response in acute-on-chronic Hep B
 15 August 2014 
Abdominal pain in IBS
 15 August 2014 
Gene expression biomarker in ulcerative colitis
 15 August 2014 
Population-based fecal immunochemical test screening
 14 August 2014 
Transnasal vs transoral endoscopy
 14 August 2014 
Radiation exposure in gastroenterology
 14 August 2014 
Dietary fibre and diverticular disease
 13 August 2014 
Fecal immunochemical test screening
 13 August 2014 
Adherence to Rome criteria in functional dyspepsia
 13 August 2014 
Flexible sigmoidoscopy screening
 12 August 2014 
Eosinophilic esophagitis and celiac disease
 12 August 2014 
Management of Lynch syndrome
 12 August 2014 
Risk of cancer under immunosuppressive therapy in IBD
 11 August 2014 
Gut microbiota in chemotherapy-induced GI mucositis
 11 August 2014 
Risk of GI bleeds with anticoagulants
 11 August 2014 
Social media in health-care
 08 August 2014 
Endoscopy nurse-administered propofol sedation performance
 08 August 2014 
Therapy for biliary tract cancer
 08 August 2014 
Surgeon volume and esophagectomy survival
 07 August 2014 
Global consensus on perianal fistulizing Crohn's disease
 07 August 2014 
Smoking cessation and age of onset of ulcerative colitis
 07 August 2014 
Colonoscopy length and training duration
 06 August 2014 
Hepatitis C virus infection in the United States
 06 August 2014 
Pediatric to adult IBD care
 06 August 2014 
Biomarker of disease activity in IBD
 05 August 2014 
Rising incidence of celiac disease
 05 August 2014 
Socioeconomic status and IBS
 05 August 2014 
Bowel dysfunction after sphincter-preserving rectal cancer surgery

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us