Tumor necrosis factor-alpha (TNF-alpha) may contribute to the progression of acute alcoholic hepatitis (AAH).
In this study, physicians from France evaluated the efficacy of infliximab and prednisolone at reducing the 2-month mortality rate among patients with severe AAH.
The team randomly assigned 36 patients with severe AAH (Maddrey score 32) to one of 2 groups. Patients in group A received intravenous infusions of infliximab (10 mg/kg) at weeks 0, 2, and 4. Patients in group B received placebo.
All patients received prednisolone (40 mg/day) for 28 days.
The team monitored patients' blood neutrophil functional capacities for 28 days.
|The frequency of severe infections was higher in group A.|
The physicians found that 7 patients in group A and 3 in group B died within 2 months of randomization, however, this difference was not significant.
The team determined that the frequency of severe infections within 2 months was higher in group A than in group B.
Dr Sylvie Naveau and colleagues concluded, "Three infusions of 10 mg/kg of infliximab in association with prednisolone may be harmful in patients with severe AAH because of the high prevalence of severe infections".