Help
Subscribe


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

 04 December 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

Steroid treatment associated with earlier onset of adverse events in children with biliary atresia

This week's publication of the Journal of the American Medical Association investigates the use of corticosteroids after hepatoportoenterostomy for bile drainage in infants with biliary atresia.

News image

Biliary atresia is the most common cause of end-stage liver disease in children.

Controversy exists as to whether use of steroids after hepatoportoenterostomy improves clinical outcome.

Dr Jorge Bezerra and colleagues determined whether the addition of high-dose corticosteroids after hepatoportoenterostomy is superior to surgery alone in improving biliary drainage and survival with the native liver.

The research team performed a multicenter, double-blind Steroids in Biliary Atresia Randomized Trial (START) in 140 infants between 2005 and 2011 in the United States.

The team's follow-up ended in January 2013.

Transplant-free survival was about 59% in the steroids group
Journal of the American Medical Association

Participants were randomized to receive intravenous methylprednisolone, and oral prednisolone followed by a tapering protocol for 9 weeks or placebo initiated within 72 hours of hepatoportoenterostomy.

The team's primary end point was the percentage of participants with a serum total bilirubin level of less than 1.5 mg/dL with his/her native liver at 6 months posthepatoportoenterostomy.

Secondary outcomes included survival with native liver at 24 months of age and serious adverse events.

The researchers found that proportion of participants with improved bile drainage was not statistically significantly improved by steroids at 6 months posthepatoportoenterostomy of placebo group.

The team observed that the adjusted absolute risk difference was 9%.

Transplant-free survival was about 59% in the steroids group, and in the placebo group at 24 months of age.

The team noted that the percentage of participants with serious adverse events was 81% of the steroids group, and 80% of the placebo group.

However, participants receiving steroids had an earlier time of onset of their first serious adverse event by 30 days posthepatoportoenterostomy.

Dr Bezerra's team concludes, "Among infants with biliary atresia who have undergone hepatoportoenterostomy, high-dose steroid therapy following surgery did not result in statistically significant treatment differences in bile drainage at 6 months, although a small clinical benefit could not be excluded."

"Steroid treatment was associated with earlier onset of serious adverse events in children with biliary atresia."

JAMA 2014;311(17):1750-1759
08 May 2014

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

 02 December 2016 
Hep E in acute liver failure
 02 December 2016 
Occurrence and severity of alcoholic hepatitis
 02 December 2016 
Food antigen in active eosinophilic esophagitis
 01 December 2016 
Iron deficiency in anemic ulcerative colitis patients
 01 December 2016 
Prognostic factors after paracetamol-induced liver failure
 01 December 2016 
Factors that influence colorectal cancer screening findings
 30 November 2016 
Certolizumab pegol in Crohn's disease
 30 November 2016 
Genetic risk of Crohn's in chronic granulomatous disease
 30 November 2016 
Rifaximin in diarrhea-predominant IBS
 29 November 2016 
Assessing liver steatosis
 29 November 2016 
Colorectal cancer surveillance in ulcerative colitis
 29 November 2016 
Treating Zenker's diverticulum
 28 November 2016 
Complications in celiac disease
 28 November 2016 
Monitoring IBD with mobile technology
 28 November 2016 
Reducing warfarin-related upper GI bleeds
 25 November 2016 
Metal vs plastic stents for pancreatic cancer surgery
 25 November 2016 
Yoga and IBS therapy 
 25 November 2016 
Colorectal cancer screening issues
 24 November 2016 
Partner burden in celiac disease
 24 November 2016 
Fusobacterium nucleatum for colorectal cancer prognosis
 24 November 2016 
PPIS and gastric cancer risk
 23 November 2016 
Diagnosing autoimmune pancreatitis
 23 November 2016 
Readmissions in cirrhosis
 23 November 2016 
Quality assurance standards for colonoscopy
 22 November 2016 
Fatigue in IBD
 22 November 2016 
PPIs and C. diff in ICU 
 22 November 2016 
Bile acid diarrhea in function bowel disorder with diarrhea
 21 November 2016 
Financial incentives and colorectal cancer screening
 21 November 2016 
Pain after endoscopic resection of gastric tumors
 21 November 2016 
Antivirals and chemotherapy in Hep C patients with cancer
 18 November 2016 
Ustekinumab in Crohn’s disease
 18 November 2016 
Colorectal cancer risk and self-reported family history
 18 November 2016 
Antivirals and chemotherapy in Hep C patients with cancer
 17 November 2016 
Liver-related specialty care in patients with Hep C
 17 November 2016 
Risk of overweight in infants
 17 November 2016 
Moderate alcohol consumption and NAFLD
 16 November 2016 
PPI therapy in liver disease
 16 November 2016 
Education in Gastroenterology fellowship
 16 November 2016 
Paternal preconceptional use of anti-TNF-α agents
 15 November 2016 
Novel treatment of NASH 
 15 November 2016 
Physician perspectives on Hep C management
 15 November 2016 
Contraceptives and ulcerative colitis
 14 November 2016 
Cardiovascular risk in NAFLD 
 14 November 2016 
Vit D and NAFLD
 14 November 2016 
Malignancy risk in IBD 
 11 November 2016 
Treatment of Hep C along with opioid agonist therapy
 11 November 2016 
Diabetes and liver cancer risk in Hep C cirrhosis
 11 November 2016 
Biomarker of cirrhosis progression
 10 November 2016 
Testosterone levels and cirrhosis outcomes in men
 10 November 2016 
Improving bowel quality before colonoscopy
 10 November 2016 
Fecal microbiota transplantation and CDI episodes
 09 November 2016 
Minimizing costs of esophagogastroduodenoscopy and colonoscopy
 09 November 2016 
Risk of TB in IBD patients receiving therapy
 09 November 2016 
Liver transplant wait-list and mortality in infants
 08 November 2016 
NSAIDS and risk of Barrett’s
 08 November 2016 
Ferritin levels and NAFLD mortality
 08 November 2016 
Alarms in the diagnosis of colorectal cancer
 07 November 2016 
BMI and fibrosis regression during Hep B
 07 November 2016 
Prognosis and biliary tract malignancies
 07 November 2016 
Post-colonoscopy colorectal cancer

Blackwell Publishing


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