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 28 May 2018

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News

Change in bilirubin in severe alcoholic hepatitis treated with prednisolone

An early change in bilirubin levels identifies nonresponders to corticosteroid treatment in patients with severe alcoholic hepatitis, find researchers in the December issue of Hepatology.

News image

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It would be useful to be able to identify early those patients with severe biopsy-proven alcoholic hepatitis who are not responding to corticosteroids.

In this study, researchers from France sought to develop simple criteria to promptly identify nonresponders to corticosteroids.

The team included 238 patients in the study.
95% of patients with early change in bilirubin levels had improved liver function during treatment.
Hepatology

They found that overall survival at 1 and 6 months was 85% and 64%, respectively.

Furthermore, they detected an early change in bilirubin levels at 7 days in 73% of the patients.

The team found that in patients who showed an early change in bilirubin levels, bilirubin decreased. While in patients without this change it increased.

They also determined that 95% of patients with early change in bilirubin levels continued to have improved liver function during treatment.

At 6 months, they found that patients with early change in bilirubin levels had significantly better survive than those patients who did not. Multivariate analysis identified early change in bilirubin levels, discriminant function and creatinine as independent prognostic variables. The team found that early change in bilirubin levels had the most important prognostic value.

Dr Philippe Mathurin's team concluded, "Early change in bilirubin levels is a very simple predictive factor for identifying nonresponders".

"A recommendation to discontinue corticosteroids after 7 days in patients without early change in bilirubin levels, suggested by our results, awaits additional confirmation".

Hepatology 2003; 38: 1363-9
02 December 2003

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