| Autor: |
Tkachenko, Petr, Maevskaya, Marina, Pavlov, Alexander, Komkova, Inna, Pavlov, Chavdar, Ivashkin, Vladimir |
| Zdroj: |
Hepatology International; Nov2016, Vol. 10 Issue 6, p983-987, 5p |
| Abstrakt: |
Purpose/background: Severe alcoholic hepatitis (AH) is a life-threatening liver disease with a potential of 30-40 % mortality at 1 month. While steroids remain to be a first line therapy, they provide only about 50 % survival benefit. The aim of the study was to evaluate the efficacy of glucocorticoids plus S-adenosylmethionine (SAMe), as compared to glucocorticoids alone, in patients with severe alcoholic hepatitis. Methods: Forty patients with severe AH were randomized in two groups and enrolled in the prospective trial. Group 1 ( n = 20) patients received prednisolone 40 mg/daily per os, and group 2 ( n = 20) patients were managed with prednisolone 40 mg/daily per os plus SAMe 800 mg i.v. treatment. Duration was 28 days. Results: The response rate assessed by Lille model was significantly higher in the prednisolone plus SAMe group (19 of 20; 95 %) than in the prednisolone group (13 of 20; 65 %), p = 0.044. Two (10 %) patients died, both from the prednisolone group. There were no lethal outcomes in the prednisolone plus SAMe group. The Kaplan-Meier method showed no significant differences between the two groups ( p = 0.151, log-rank). Hepatorenal syndrome (HRS) occurred in 20 % in the prednisolone group (4 of 20 patients) while no HRS cases were registered in the prednisolone plus SAMe group ( p = 0.035). Conclusions: Management of severe alcoholic hepatitis with prednisolone plus SAMe was associated with better therapy response ( p = 0.044) and less frequent HRS occurrence ( p = 0.035). Mortality was not significantly lower in the prednisolone-SAMe group than in the prednisolone-only group at 28 days (10 vs. 0 %, p = 0.151). [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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