Help
Subscribe


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

 03 May 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

 03 May 2016 
PPIs and gut microbiota
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Resection of colorectal polyps
 29 April 2016 
HCV infection in Baby Boomers with Medicare
 29 April 2016 
Simvastatins and survival in cirrhosis
 29 April 2016 
Crohn's disease associated genes
 28 April 2016 
Diarrheal diseases in children
 28 April 2016 
Birth outcomes in women with IBD receiving assisted reproduction
 28 April 2016 
Racial disparities in survival from colon cancer
 27 April 2016 
Celiac disease in adults
 27 April 2016 
Ultra-short celiac disease
 27 April 2016 
Dust mite and human GI tract
 26 April 2016 
Guidelines for nutrition therapy in hospitalized patients
 26 April 2016 
Polyp detection during colonoscopy
 26 April 2016 
IBS and microscopic colitis
 25 April 2016 
Estrogen deficiency and fibrosis risk in women with NAFLD
 25 April 2016 
Acceptance of Liver transplant center organ offers
 25 April 2016 
Abrupt interruption of beta-blockers in cirrhosis 
 22 April 2016 
Novel method to regenerate the esophagus
 22 April 2016 
Relapse after antiviral treatment in Hep B
 22 April 2016 
Microscopic colitis with NSAIDs and PPIs
 11 April 2016 
Infliximab vs adalimumab in ulcerative colitis
 11 April 2016 
H. pylori in treatment-naïve children
 11 April 2016 
Admissions times and outcomes for ERCP cholangitis
 08 April 2016 
Endoscopic treatment of Crohn's strictures
 08 April 2016 
Nutrition therapy in the hospitalized patient
 08 April 2016 
H.pylori effects on pediatric gastric mucosa
 07 April 2016 
CVD changes after TIPSS
 07 April 2016 
Transanal mesorectal resection for rectal cancer
 07 April 2016 
HBV during immunosuppressive therapies
 06 April 2016 
Adherence to colorectal cancer screening strategies
 06 April 2016 
Duodenal bulb biopsies in childhood celiac disease diagnosis
 06 April 2016 
Lymph node metastasis in early gastric cancer
 05 April 2016 
IBS in the US military
 05 April 2016 
Changes in blood flow in cirrhosis
 05 April 2016 
Colorectal cancer risk with serrated polyps
 04 April 2016 
Noninvasive diagnosis of celiac disease
 04 April 2016 
Metallic vs plastic stents for benign biliary strictures
 04 April 2016 
Adherence to quality indicators improves clinical outcomes in ascites
 01 April 2016 
Prognosis after colorectal cancer resection with peritoneal metastasis
 01 April 2016 
Colorectal cancer risk with non-malignant colonoscopy findings
 01 April 2016 
Intensive enteral nutrition and severe alcoholic hepatitis
 31 March 2016 
Anesthesia services during colonoscopy
 31 March 2016 
Management of Barrett’s esophagus
 31 March 2016 
Alcohol and glucose tolerance in NAFLD
 30 March 2016 
Depression and symptoms in IBS
 30 March 2016 
Electronic learning system for colon capsule endoscopy
 30 March 2016 
Gastric cancer screening
 29 March 2016 
Statins and survival in esophageal cancer
 29 March 2016 
Infant feeding practices and celiac disease
 25 March 2016 
Medical therapy and neoplasia regression in familial adenomatous polyposis
 25 March 2016 
Medical therapy compliance and ulcerative colitis recurrence
 25 March 2016 
Predicting outcomes of drug-induced acute liver failure
 24 March 2016 
Thrombocytopenia and multi-organ system failure in acute liver failure
 24 March 2016 
Patients with ulcerative colitis and their concerns
 24 March 2016 
Prediction of relapses in IBD
 23 March 2016 
Thiopurine therapy in IBD

Blackwell Publishing


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