Help
Subscribe


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

 20 April 2018

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

Predicting response to corticosteroids and mortality in severe alcoholic hepatitis

A day-4 Lille Model predicts response to corticosteroids and mortality in severe alcoholic hepatitis, reports this month's American Journal of Gastroenterology.

News image

Prednisolone therapy increases the risk of infections in patients with severe alcoholic hepatitis. 

Dr Mauricio Garcia-Saenz-de-Sicilia and colleagues from Arkansas, USA evaluated whether the use of the Lille Model at day 4 is useful to predict response to prednisolone compared with the classic day 7 in order to limit a futile exposure to corticosteroids.

The research team performed a retrospective analysis of a large multinational cohort of patients with severe alcoholic hepatitis with Maddrey’s discriminant function ≥32. 

The team assessed response to corticosteroids with Lille Model at day 4 and 7, according to the validated cutoff value. 

A total of 63% of 260 patients received corticosteroids
American Journal of Gastroenterology
Receiver operating characteristics curves were constructed to determine the optimal cutoff value for Lille Model at day 4, and to compare accuracy between Lille Model at day 4, Lille Model at day 7, MELD (Model for End-Stage Liver Disease), and ABIC (age, bilirubin, international normalized ratio, and creatinine).
 
The team predicted 28- and 90-day mortality, and assessed long-term survival.

The researchers reported that a total of 63% of 260 patients received corticosteroids.

The team found that the median discriminant function for the patients treated with corticosteroids was 64. 

Overall 90-day mortality was 36%. 

The research team observed that the median Lille Model at day 4 and 7 for the patients who received treatment was 0.39, and 0.36. 

Lille Model at day 4 was a strong independent predictor of 28-day mortality. 

By using Lille Model at day 4 with a cutoff >0.45, the team noted that 28- and 90-day survival was significantly higher for responders than non-responders. 

Importantly, the area under the curve for predicting mortality for LM4 was similar than the classic Lille Model at day 7.

Dr Garcia-Saenz-de-Sicilia's team concludes, "Lille Model at day 4 is as accurate as at day 7 in predicting response to corticosteroids, as well as 28- and 90-day mortality."

'Assessing the efficacy of prednisolone at an earlier time point can avoid a more prolonged futile use of this therapy."

Am J Gastroenterol 2017; 112:306–315
22 February 2017

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

 20 April 2018 
Obesity and physical activity in diverticulosis
 20 April 2018 
Worldwide H.pylori prevalence
 20 April 2018 
Adalimumab with azathioprine in Crohn's
 20 April 2018 
Antibody suitable for further clinical development to complement existing therapeutic strategies for HCV
 19 April 2018 
Fibrosis in patients with chronic hepatitis B
 19 April 2018 
c-Myc expression and pancreatic cancer
 19 April 2018 
Olmesartan prescription in the USA
 18 April 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 18 April 2018 
Hep C treatment for sustained virologic response
 18 April 2018 
Endoscopic necrosectomy reduces risk of death 
 17 April 2018 
Colorectal cancer screening and ethnic inequities
 17 April 2018 
Training programs should consider radiation education for advanced endoscopy fellows
 17 April 2018 
Aspirin and pancreatic cancer
 16 April 2018 
Surgery for colorectal polyps has increased 
 16 April 2018 
Advanced fibrosis can be ruled out in primary health care patients
 16 April 2018 
Antibiotic use and colorectal adenoma
 13 April 2018 
Colorectal cancer cell lines
 13 April 2018 
Infliximab and corticosteroid-free clinical remission in Crohn's
 13 April 2018 
Teduglutide for children with short bowel syndrome
 12 April 2018 
Prescriptions for opiate drugs amongst primary care patients with IBD
 12 April 2018 
Lower GI bleeding related to comorbidity
 12 April 2018 
non–Clostridium difficile bacterial infections in IBD
 11 April 2018 
Physician perception of IBD trial results
 11 April 2018 
Bile acid deficiency in IBS 
 11 April 2018 
Stem cell therapy for fistulas in Crohn's
 10 April 2018 
Overweight in childhood and type 2 diabetes
 10 April 2018 
immunoglobulin G associates with clinical features of IBD
 10 April 2018 
T-cells repertoires in celiac disease
 09 April 2018 
Biomarker tests for colorectal cancer screening
 09 April 2018 
Fecal transplantation in C. difficile infection and treatment outcome 
 09 April 2018 
No weigh-loss drug improved all cardiometabolic risk factors
 06 April 2018 
Colonoscopy and colorectal cancer mortality
 06 April 2018 
Eosinophilic esophagitis and health-related quality of life
 06 April 2018 
Microbiome in athletes vs sedentary subjects
 05 April 2018 
Laparoscopic Nissen fundoplication for GERD treatment
 05 April 2018 
Random biopsies for neoplasia in IBD
 05 April 2018 
Scoring system identifies cancer risk in Barrett's
 04 April 2018 
Alpha‐1 antitrypsin deficiency and liver disease
 04 April 2018 
PPI and risk of stroke
 04 April 2018 
Adjuvant chemotherapy for advanced colon cancer
 29 March 2018 
Prevention of metachronous gastric cancer
 29 March 2018 
Acute lower GI bleeding
 28 March 2018 
Decision aid used by IBD patients
 28 March 2018 
Transition for young adults with IBD
 28 March 2018 
Amitriptyline in functional dyspepsia
 27 March 2018 
Emergency department utilization for IBD 
 27 March 2018 
Management of hemorrhoids in the USA
 27 March 2018 
Adult ulcerative colitis
 26 March 2018 
Biological therapy response in IBD 
 26 March 2018 
Obesity and diverticulosis
 26 March 2018 
Practice guidelines for chronic constipation
 23 March 2018 
Health-related quality of life in eosinophilic esophagitis
 23 March 2018 
Genetics and chronic liver disease
 23 March 2018 
Global prevalence of H.pylori
 22 March 2018 
H. pyloris and gastric cancer
 22 March 2018 
Pancreatitis after IBS treatment 
 22 March 2018 
Mechanisms of action in patients with IBS
 21 March 2018 
Panel markers for early detection of colon cancer

 21 March 2018 
Blood test differentiates celiac disease
 21 March 2018 
Patient characteristics and colonoscopy preparation

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us