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Keywords Prednisolone or Pentoxifylline...

Prednisolone or Pentoxifylline for Alcoholic Hepatitis

https://read.qxmd.com/read/38531032/an-update-on-treatment-and-outcomes-for-alcoholic-hepatitis
#1
JOURNAL ARTICLE
Elizabeth Brakebush
Alcoholic hepatitis is a form of inflammation of the liver caused by alcohol use. Data on the best treatment are conflicting. Treatment guidelines include the use of prednisolone and supportive care, although this is controversial. This article reviews the guidelines for treating alcoholic hepatitis and current recommendations.
April 1, 2024: JAAPA: Official Journal of the American Academy of Physician Assistants
https://read.qxmd.com/read/38011683/granulocyte-colony-stimulating-factor-plus-pentoxifylline-increases-short-term-survival-in-patients-with-severe-alcoholic-hepatitis-a-network-meta-analysis
#2
REVIEW
Fangfang Duan, Chen Liu, Chunyan Chang, Shanshan Song, Hang Zhai, Jun Cheng, Song Yang
Background: Optimal treatments for severe alcoholic hepatitis (SAH) remain controversial. Previous network meta-analysis showed that corticosteroid (CS) combined with N-acetylcysteine (NAC) was superior in reducing short-term mortality of patients with SAH. Recently, granulocyte colony-stimulating factor (G-CSF) treatments for SAH yielded promising results. Objectives: To determine how currently available treatments affect the survival and complications of patients with SAH. Methods: The study was conducted following the guidelines of PRISMA...
November 27, 2023: American Journal of Drug and Alcohol Abuse
https://read.qxmd.com/read/37994498/a-novel-score-of-il-13-and-age-predicts-90-day-mortality-in-severe-alcohol-associated-hepatitis-a-multicenter-plasma-biomarker-analysis
#3
MULTICENTER STUDY
David Tornai, Mack Mitchell, Craig J McClain, Srinivasan Dasarathy, Arthur McCullough, Svetlana Radaeva, Aimee Kroll-Desrosiers, JungAe Lee, Bruce Barton, Gyongyi Szabo
BACKGROUND: Severe alcoholic hepatitis (AH) has a high short-term mortality rate. The MELD assesses disease severity and mortality; however, it is not specific for AH. We screened plasma samples from patients with severe AH for biomarkers of multiple pathological processes and identified predictors of short-term mortality. METHODS: Plasma was collected at baseline from 85 patients with severe AH (MELD≥20, Maddrey's discriminant function≥32) enrolled in the Defeat Alcoholic Steatohepatitis clinical trial (investigating IL-1 receptor antagonist+pentoxifylline+zinc vs...
December 1, 2023: Hepatology Communications
https://read.qxmd.com/read/37907805/severity-of-acute-portal-hypertension-determines-the-clinical-outcomes-in-severe-alcoholic-hepatitis
#4
JOURNAL ARTICLE
Ankur Jindal, Manoj K Sharma, Rajan Vijayaraghavan, Shasthry Sm, Guresh Kumar, Shiv K Sarin
BACKGROUND: Severe alcohol-associated hepatitis (SAH) presenting as acute-on-chronic liver failure (ACLF) has high mortality. Severe hepatic inflammation and ongoing hepatocellular cell death lead to rapid rise in portal pressure, a hyperdynamic circulation that might precipitate infections and organ failures. METHODS: Consecutive SAH patients were classified based on baseline HVPG measurement as 6to < 12 mmHg, 12to < 20 mmHg, and ≥ 20 mmHg...
October 31, 2023: Digestive Diseases and Sciences
https://read.qxmd.com/read/37781965/in-severe-alcohol-related-hepatitis-acute-kidney-injury-is-prevalent-associated-with-mortality-independent-of-liver-disease-severity-and-can-be-predicted-using-il-8-and-micro-rnas
#5
JOURNAL ARTICLE
Luke D Tyson, Stephen Atkinson, Robert W Hunter, Michael Allison, Andrew Austin, James W Dear, Ewan Forrest, Tong Liu, Emma Lord, Steven Masson, Joao Nunes, Paul Richardson, Stephen D Ryder, Mark Wright, Mark Thursz, Nikhil Vergis
BACKGROUND: The prevalence, prediction and impact of acute kidney injury (AKI) in alcohol-related hepatitis (AH) is uncertain. AIMS: We aimed to determine AKI incidence; association with mortality; evaluate serum biomarkers and the modifying effects of prednisolone and pentoxifylline in the largest AH cohort to date. METHODS: Participants in the Steroids or Pentoxifylline for Alcoholic Hepatitis trial with day zero (D0) creatinine available were included...
December 2023: Alimentary Pharmacology & Therapeutics
https://read.qxmd.com/read/37568158/a-multicenter-double-blind-placebo-controlled-randomized-trial-to-evaluate-the-safety-and-efficacy-of-bovine-colostrum-in-the-treatment-of-severe-alcoholic-hepatitis-sah
#6
JOURNAL ARTICLE
S S Sidhu, A Dusseja, Shalimar, S Nijhawan, D Kapoor, O Goyal, H Kishore
BACKGROUND: Severe alcoholic hepatitis (SAH) is associated with high mortality. Numerous studies and meta-analysis have reported that corticosteroids reduce the 28-day mortality in SAH, but not the 6-month mortality. Therefore, newer treatments for SAH need to be studied. A pilot study from our group had recently treated ten patients with SAH with bovine colostrum (BC) [20 g thrice in a day for 8 weeks] and prednisolone. This therapy improved the biological functions and 3-month mortality...
August 11, 2023: Trials
https://read.qxmd.com/read/37455447/risk-factors-for-fractures-following-liver-transplantation-a-population-based-cohort-study
#7
JOURNAL ARTICLE
Jei-Wen Chang, Hui-Hsin Yang, Niang-Cheng Lin, Fang-Cheng Kuo, Tzu-Ching Lin, Hsin-Lin Tsai
BACKGROUND: Liver transplant recipients have an increased risk of osteoporosis and fractures. The aim of this study was to identify risk factors for fractures after liver transplant in a Taiwanese population. METHODS: We identified newly diagnosed liver transplant recipients from the National Health Insurance Research Database in Taiwan between 2003 and 2015. Risk factors of post-transplant fractures were analyzed using a Cox proportional hazards model. RESULTS: A total of 4821 patients underwent liver transplantation, of whom 419 (8...
December 2023: Annals of Medicine
https://read.qxmd.com/read/37302838/-a-case-of-severe-alcoholic-hepatitis-successfully-treated-with-granulocytapheresis
#8
JOURNAL ARTICLE
Emiri Miyazaki, Masayuki Miyazaki, Makoto Hara, Yuichi Tachibana, Akihiro Ueda, Tetsuro Akashi
A 46-year-old male patient with a drinking history presented at our hospital with jaundice. He was diagnosed with moderate alcoholic hepatitis based on laboratory data. The white blood cell (WBC) counts were gradually increased and the prothrombin time was prolonged after hospitalization. Methylprednisolone (1000mg/day for 3 days) followed by oral prednisolone (40mg/day) was administered. However, the liver function was not improved and the patient progressed to severe alcoholic hepatitis. Therefore, we performed granulocytapheresis (GCAP)...
2023: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://read.qxmd.com/read/37300449/current-and-future-treatment-for-alcoholic-related-liver-diseases
#9
REVIEW
Eileen L Yoon, Won Kim
The socioeconomic burden of alcohol-related liver disease has been increasing worldwide. Its prevalence is underestimated, and patients with alcohol-related liver disease are rarely diagnosed in the earlier phase of the disease spectrum. Alcoholic hepatitis is a distinct syndrome with life-threatening signs of systemic inflammation. In severe alcoholic hepatitis, prednisolone is indicated as the first-line treatment even with the possibility of various complications. Early liver transplantation can be another option for highly selected patients with a null response to prednisolone...
August 2023: Journal of Gastroenterology and Hepatology
https://read.qxmd.com/read/37278488/granulocyte-colony-stimulating-factor-with-or-without-stem-or-progenitor-cell%C3%A2-or-growth-factors-infusion-for-people-with-compensated-or-decompensated-advanced-chronic-liver-disease
#10
REVIEW
Agostino Colli, Mirella Fraquelli, Daniele Prati, Giovanni Casazza
BACKGROUND: Advanced chronic liver disease is characterised by a long compensated phase followed by a rapidly progressive 'decompensated' phase, which is marked by the development of complications of portal hypertension and liver dysfunction. Advanced chronic liver disease is considered responsible for more than one million deaths annually worldwide. No treatment is available to specifically target fibrosis and cirrhosis; liver transplantation remains the only curative option. Researchers are investigating strategies to restore liver functionality to avoid or slow progression towards end-stage liver disease...
June 6, 2023: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/37250885/a-review-on-il-1-receptor-antagonist-plus-pentoxifylline-and-zinc-for-severe-alcohol-associated-hepatitis
#11
JOURNAL ARTICLE
Shrihari Anikhindi, Akshay Anikhindi, Ashish Kumar, Anil Arora
No abstract text is available yet for this article.
2023: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/37159035/effect-of-prophylactic-antibiotics-on-mortality-in-severe-alcohol-related-hepatitis-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Alexandre Louvet, Julien Labreuche, Thong Dao, Thierry Thévenot, Frédéric Oberti, Christophe Bureau, Thierry Paupard, Eric Nguyen-Khac, Anne Minello, Brigitte Bernard-Chabert, Rodolphe Anty, Faustine Wartel, Nicolas Carbonell, Georges-Philippe Pageaux, Marie-Noelle Hilleret, Romain Moirand, Pierre Nahon, Camille Potey, Alain Duhamel, Philippe Mathurin
IMPORTANCE: The benefits of prophylactic antibiotics for hospitalized patients with severe alcohol-related hepatitis are unclear. OBJECTIVE: To determine the efficacy of amoxicillin-clavulanate, compared with placebo, on mortality in patients hospitalized with severe alcohol-related hepatitis and treated with prednisolone. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized, double-blind clinical trial among patients with biopsy-proven severe alcohol-related hepatitis (Maddrey function score ≥32 and Model for End-stage Liver Disease [MELD] score ≥21) from June 13, 2015, to May 24, 2019, in 25 centers in France and Belgium...
May 9, 2023: JAMA
https://read.qxmd.com/read/36950492/acute-kidney-injury-aki-at-admission-predicts-mortality-in-patients-with-severe-alcoholic-hepatitis-sah
#13
JOURNAL ARTICLE
Chitta R Khatua, Manas K Panigrahi, Ashok K Choudhury, Gautam Nath, Reshu Khandelwal, Prajna Anirvan, Shivaram P Singh
BACKGROUND & AIMS: Severe alcoholic hepatitis (SAH) is a grave condition, and the presence of acute kidney injury (AKI) further jeopardizes patient survival. However, the impact of AKI on survival in SAH has not been assessed from this region of Asia. MATERIALS AND METHODS: This study was conducted on consecutive alcohol-associated liver disease (ALD) patients hospitalized in Gastroenterology Department, SCB Medical College, Cuttack, India, between October 2016 and December 2018...
2023: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/36855497/familial-primary-biliary-cholangitis-with-different-clinical-courses-based-on-anti-gp210-antibody-positivity-a-report-of-two-cases
#14
Takahiro Nagata, Yasuaki Takeyama, Satoshi Shakado, Fumihito Hirai, Satoshi Nimura
A 30-year-old woman (daughter) was diagnosed to have primary biliary cholangitis (PBC) with autoimmune hepatitis (AIH) overlap syndrome. Although she was started on prednisolone and ursodeoxycholic acid (UA), she eventually died of hepatic failure with gastrointestinal hemorrhage seven months after the initial hospitalization. A 60-year-old woman (mother) was diagnosed with PBC with alcoholic liver cirrhosis, was treated with UA, and had no disease progression. These familial PBC patients had different clinical courses...
January 2023: Curēus
https://read.qxmd.com/read/36817307/hepatitis-of-an-unknown-etiology-with-concomitant-itp
#15
Ariana Tagliaferri, Brooke Kania, Dhruv Patel, Iqra Baig, Alisa Farokhian, Angelo Bellardini
Alcoholic hepatitis (AH) usually presents after decades of alcohol consumption and can even manifest with recent abstinence. The clinical presentation may be compounded by underlying liver cirrhosis and liver function enzymes are not a reliable means of diagnosing AH due to poor sensitivity and specificity. One feature of alcoholic hepatitis is thrombocytopenia; however, patients may also have thrombocytopenia due to another underlying condition, such as Immune Thrombocytopenic Purpura (ITP). ITP is an autoimmune disease caused by autoantibodies against platelet glycoproteins...
2023: Journal of Community Hospital Internal Medicine Perspectives
https://read.qxmd.com/read/36479155/clinical-outcomes-and-gut-microbiota-analysis-of-severe-alcohol-associated-hepatitis-patients-undergoing-healthy-donor-fecal-transplant-or-pentoxifylline-therapy-single-center-experience-from-kerala
#16
JOURNAL ARTICLE
Cyriac Abby Philips, Rizwan Ahamed, Sasidharan Rajesh, Shobhit Singh, Ajit Tharakan, Jinsha K Abduljaleel, Philip Augustine
BACKGROUND: Severe alcohol-associated hepatitis (SAH) patients with infections have a high short-term mortality rate. Gut microbiota dysbiosis plays an important role in the pathogenesis of SAH. Preliminary studies have demonstrated long-term benefits with healthy donor fecal microbiota transplantation (FMT). Data on FMT compared with pentoxifylline for SAH and relevant gut microbial changes are lacking in literature. METHODS: From January 2019 to February 2021, retrospective analysis of a single hospital's records revealed 47 SAH patients undergoing FMT (100 mL/day via nasoduodenal tube for 7 days) and 25 matched patients receiving pentoxifylline (400 mg/8 h for 28 days)...
2022: Gastroenterology Report
https://read.qxmd.com/read/36469298/fecal-microbiota-transplantation-compared-with-prednisolone-in-severe-alcoholic-hepatitis-patients-a-randomized-trial
#17
RANDOMIZED CONTROLLED TRIAL
Apurva Pande, Shvetank Sharma, Vikas Khillan, Archana Rastogi, Vinod Arora, Saggere Muralikrishna Shasthry, Rajan Vijayaraghavan, Rakesh Jagdish, Manoj Kumar, Guresh Kumar, Stanislas Mondot, Joél Dore, Shiv K Sarin
BACKGROUND: Severe alcoholic hepatitis (SAH) has high 90-day mortality. Prednisolone therapy has shown modest survival benefits over placebo at 28 but not 90 days. Fecal microbial transplantation (FMT) has shown promise in these patients. We compared the efficacy and safety of the two therapies in SAH patients. METHODS: Steroid eligible SAH patients were randomized in an open-label study to prednisolone (n = 60) 40 mg/day for 28 days (assessed at day-7 for continuation) or healthy donor FMT (n = 60) through naso-duodenal tube, daily for seven days...
February 2023: Hepatology International
https://read.qxmd.com/read/36278756/narrative-review-glucocorticoids-in-alcoholic-hepatitis-benefits-side-effects-and-mechanisms
#18
REVIEW
Hong Lu
Alcoholic hepatitis is a major health and economic burden worldwide. Glucocorticoids (GCs) are the only first-line drugs recommended to treat severe alcoholic hepatitis (sAH), with limited short-term efficacy and significant side effects. In this review, I summarize the major benefits and side effects of GC therapy in sAH and the potential underlying mechanisms. The review of the literature and data mining clearly indicate that the hepatic signaling of glucocorticoid receptor (GR) is markedly impaired in sAH patients...
September 21, 2022: Journal of Xenobiotics
https://read.qxmd.com/read/36267499/a-phase-ii-multicenter-open-label-randomized-trial-of-pegfilgrastim-for-patients-with-alcohol-associated-hepatitis
#19
JOURNAL ARTICLE
John A Tayek, Andrew A Stolz, Danh V Nguyen, M Wayne Fleischman, John A Donovan, Joseph M Alcorn, Daniel C-K Chao, Aliya Asghar, Timothy R Morgan
BACKGROUND: In trials conducted in India, recombinant granulocyte colony stimulating factor (GCSF) improved survival in alcohol-associated hepatitis (AH). The aim of this trial was to determine the safety and efficacy of pegfilgrastim, a long-acting recombinant GCSF, in patients with AH in the United States. METHODS: This prospective, randomized, open label trial conducted between March 2017 and March 2020 randomized patients with a clinical diagnosis of AH and a Maddrey discriminant function score ≥32 to standard of care (SOC) or SOC+pegfilgrastim (0...
December 2022: EClinicalMedicine
https://read.qxmd.com/read/36157148/current-medical-treatment-for-alcohol-associated-liver-disease
#20
REVIEW
Gustavo Ayares, Francisco Idalsoaga, Luis A Díaz, Jorge Arnold, Juan P Arab
Alcohol-associated liver disease is one of the main causes of chronic liver disease. It comprises a clinical-histologic spectrum of presentations, from steatosis, steatohepatitis, to different degrees of fibrosis, including cirrhosis and severe necroinflammatory disease, called alcohol-associated hepatitis. In this focused update, we aim to present specific therapeutic interventions and strategies for the management of alcohol-associated liver disease. Current evidence for management in all spectra of manifestations is derived from general chronic liver disease recommendations, but with a higher emphasis on abstinence and nutritional support...
2022: Journal of Clinical and Experimental Hepatology
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