Pentoxifylline versus prednisolone for severe alcoholic hepatitis:

A randomized controlled trial 

Autores: Bosques Padilla Francisco Javier, Vázquez Elizondo Genaro, Martínez Vázquez Manuel Alejandro, Maldonado Garza Héctor Jesús

Resumen

Aim: To compare the efficacy of pentoxifylline and prednisolone in the treatment of severe lcoholic hepatitis and to evaluate the role of different liver function scores in predicting prognosis. Methods: Sixty-eight patients with severe alcoholic hepatitis (Maddrey score³ 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.

Palabras clave: Alcoholic hepatitis pentoxifylline prednisolone maddrey discriminant function score model for end-stage liver disease score glasgow alcoholic hepatitis score.

2009-12-04   |   2,749 visitas   |   Evalua este artículo 0 valoraciones

Vol. 8 Núm.4. Octubre-Diciembre 2009 Pags. 402-404 Ann Hepatol 2009; 8(4)