Pentoxifylline and prednisolone in severe alcoholic hepatitis

• Published in: Annals of hepatology Vol. 8; no. 4; pp. 402 - 404
• Main Authors: Francisco J. Bosques-Padilla, Genaro Vázquez-Elizondo, Manuel A. Martínez Vázquez, Héctor J. Maldonado-Garza
• Format: Journal Article
• Language: English
• Published: Elsevier 01-10-2009
• Subjects: Alcoholic hepatitis; Glasgow alcoholic hepatitis score; Maddrey discriminant function score; Model for end-stage liver disease score; Pentoxifylline; Prednisolone
• ISSN: 1665-2681
• DOI: 10.1016/s1665-2681(19)31760-0

Original Abstract: Aim. To compare the efficacy of pentoxifylline and prednisolone in the treatment of severe alcoholic hepatitis and to evaluate the role of different liver function scores in predicting prognosis.Methods. Sixty-eight patients with severe alcoholic hepatitis (Maddrey score 3 32) received pentoxifylline (n = 34, group I) or prednisolone (n = 34, group II) for 28 d in a randomized double-blind controlled study, and subsequently in an open study (with a tapering dose of prednisolone) for a total of 3 mo, and were followed up over a period of 12 mo.Results. Twelve patients in group II died at the end of 3 mo in contrast to five patients in group I. The probability of dying at the end of 3 mo was higher in group II as compared to group I (35.29% vs. 14.71%, p = 0.04; log rank test). Six patients in group II developed hepatorenal syndrome as compared to none in group I. Pentoxifylline was associated with a significantly lower model for end-stage liver disease (MELD) score at the end of 28 d of therapy (15.53 ± 3.63 vs 17.78 ± 4.56, p = 0.04). Higher baseline Maddrey score was associated with increased mortality.Conclusion. Reduced mortality, improved risk-benefit profile and renoprotective effects of pentoxifylline compared with prednisolone suggest that pentoxifylline is superior to prednisolone for treatment of severe alcoholic hepatitis.