Bosques-Padilla FJ, Vázquez-Elizondo G, Martínez-Vázquez MA, Maldonado-Garza HJ

Language: English
References: 0
Page: 402-404
PDF size: 122.54 Kb.

ABSTRACT

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 score^ł 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.