New insights into treatment options for patients suffering from severe alcoholic hepatitis

Apr 16, 2010

Results from two French studies presented today at the International Liver Congress 2010 press conference will help inform clinical practice in the treatment of patients with severe or acute alcoholic hepatitis.

The first study demonstrated the positive potential of performing for patients suffering from severe alcoholic hepatitis (SAH) earlier than the recommended 6-months rule (required minimum of recorded abstinence for an alcoholic patient to be eligible for a ). Indeed, those patients who do not respond to treatment with have a 6-month survival of around 30% and most deaths actually occur within 2-months. The results show that early liver transplantation could be proposed to non-respondents, pending a very careful evaluation of selected patients.

Acute alcoholic hepatitis (AAH) however, is an absolute contraindication for liver transplantation. It has a low survival rate, with mortality remaining at around 35% at 6 months despite corticoid treatment, the current standard of care for the condition. The second study presented today will help inform a potential new treatment option for those patients who do not respond to standard treatment with corticoid. Data demonstrated that treatment with combined corticoids plus N-acetyl cysteine (C+NAC) showed an increase in survival rates. There have been few, large, well-designed trials advocating the use of N-acetyl cysteine to slow progression of liver disease. This latest study adds to the growing body of evidence in the benefits of treatment with C+NAC in patients with acute liver disease.

Professor Philippe Mathurin from the Hôpital Huriez, CHRU Lille, France who presented the results commented: "Whilst the management of alcoholic is steeped in controversy, as clinicians we have a responsibility to treat these patients in the most effective way possible, and as researchers we have a mandate to highlight new options.

These latest results across large patient cohorts are the sort of clinical studies that are vital to help guide best practice in the treatment pathway for difficult-to-treat patients with a challenging medical history. Alongside education and, ideally, prevention strategies we can achieve some successful outcomes."

Explore further: UN implores all countries to help on Ebola

More information: References:

Castel et al. Early transplantation improved survival of non-responders to corticosteroids in severe alcoholic hepatitis: a challenge of the 6 month rule of abstinence. Abstract presented at The International Liver CongressTM 2010

Nguyen-Khac et al. Treatment of severe Acute Alcoholic Hepatitis (AAH) with Corticoids plus N-Acetyl Cysteine (C+NAC) versus Corticoid alone (C): a multicenter, randomized control trial. Abstract presented at ILC 2010.

Louvet A et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology 2007; 45:1348-54.

Lucey M et al. Alcoholic Hepatitis. N Engl J Med 2009; 360: 2758-2769

Provided by European Association for the Study of the Liver

4 /5 (1 vote)
add to favorites email to friend print save as pdf

Related Stories

Mayo Clinic seeks new therapies for alcoholic hepatitis

Dec 01, 2008

A new study from Mayo Clinic finds the use of the drug therapy etanercept ineffective in treating alcoholic hepatitis, an acute inflammation of the liver caused by excessive consumption of alcohol. The results of the study ...

Recommended for you

Obama addresses West Africans on facts about Ebola

7 hours ago

President Barack Obama urged West Africans on Tuesday to wear gloves and masks when caring for Ebola patients or burying anyone who died of the disease. He also discouraged the traditional burial practice ...

Gluten-free diet benefits asymptomatic EmA+ adults

7 hours ago

(HealthDay)—Asymptomatic individuals with endomysial antibodies (EmA) benefit from a gluten-free diet (GFD), according to a study published in the September issue of Gastroenterology.

Another US health worker infected with Ebola

7 hours ago

A third American health worker has tested positive for the Ebola virus while working with patients in West Africa, the Christian missionary group SIM said Tuesday.

UN implores all countries to help on Ebola

9 hours ago

The international group Doctor Without Borders warned Tuesday that the world is 'losing the battle' against Ebola, while U.N. officials implored all countries to quickly step up their response by contributing health experts ...

Travel restrictions could worsen Ebola crisis: experts

13 hours ago

Travel restrictions could worsen West Africa's Ebola epidemic, limiting medical and food supplies and keeping out much-needed doctors, virologists said Tuesday as the disease continued its deadly spread.

User comments : 0