ALCOHOLIC HEPATITIS


Moderate (1-mo) course of steroids in severe alcoholic hepatitis may improve survival over short term (1y) (NEJM 326:507, 1992 and Gastroent. 110:1847, 1996-JW)

Pentoxifylline (possible b/c of it's TNF-synthesis-inhibiting properties): 101 pts with severe alcoholic hepatitis randomized to pentoxifylline 400mg TID vs. placebo; pentoxifylline group had sig. less 28d mortality (24% vs. 46%) and less incidence of hepatorenal syndrome (8% vs. 35%) (Gastroent. 119:1637, 2000--JW)

36 pts with acute alcoholic hepatitis randomized to infliximab 10mg/kg Q2wks x 3 doses vs. placebo; all pts received prednisolone 40mg/d x 28d.  Over 2mo f/u, no sig. diff. in mortality; infliximab group had sig. higher incidence of severe infections (Hepatology 39:1390, 2004--abst)