Is pentoxifylline effective in alcoholic hepatitis?
| Autor: | Matías Arteaga, Gabriel Rada |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Pathology Phosphodiesterase Inhibitors Alcoholic hepatitis lcsh:Medicine macromolecular substances Gastroenterology Pentoxifylline Internal medicine medicine Humans Glucocorticoids lcsh:R5-920 business.industry Hepatitis Alcoholic Tumor Necrosis Factor-alpha lcsh:R General Medicine medicine.disease Clinical research Treatment Outcome Steroid use Tumor necrosis factor alpha Upper gastrointestinal bleeding business lcsh:Medicine (General) medicine.drug |
| Zdroj: | Medwave, Vol 14, Iss 06, Pp e6002-e6002 (2014) |
| ISSN: | 0717-6384 |
| Popis: | Steroidal therapy benefits patients with severe alcoholic hepatitis. However, steroid use is associated with severe side effects like infections and possibly, upper gastrointestinal bleeding. Pentoxifyllin, an inhibitor of Tumor Necrosis Factor has fewer side effects, but its effectiveness is not clear, nor its potential benefits as an adjunctive therapy to steroids.We used Epistemonikos database, which is mantained through searches in 19 databases, to find systematic reviews and their included primary studies. A structured summary was created using a predefined format that includes key messages, a summary of the body of evidence (presented as a matrix of evidence in Epistemonikos), and a summary of findings table using the GRADE approach, along with other factors that aid decision-making.Pentoxifyllin probably reduces mortality when compared with placebo. Pentoxifyllin could be less effective than steroid therapy for reducing mortality. Addition of pentoxifyllin to steroid therapy does not reduce mortality. Most practice guidelines have not taken into account an important portion of the existing evidence, even though their recommendations are in accordance with the present review.Los corticoides tienen beneficios en pacientes con hepatitis alcohólica grave, pero se asocian a un aumento de afectos adversos importantes, principalmente infecciones y probablemente hemorragia digestiva alta. Se ha estudiado el efecto de la pentoxifilina, un inhibidor del factor de necrosis tumoral oral que tiene menos efectos adversos, pero no está claro si es efectiva o si su adición a corticoides agrega beneficios.Utilizamos la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 19 bases de datos, para identificar revisiones sistemáticas y sus estudios primarios incluidos. Con esta información generamos un resumen estructurado siguiendo un formato preestablecido, que incluye mensajes clave, un resumen del conjunto de evidencia (presentado como matriz de evidencia en Epistemonikos), tablas de resumen de resultados con el método GRADE, y otras consideraciones para la toma de decisión.La pentoxifilina probablemente disminuye la mortalidad en comparación con placebo. La pentoxifilina podría ser menos efectiva que los corticoides en disminuir la mortalidad. La adición de pentoxifilina al tratamiento con corticoides no disminuye la mortalidad. Las principales guías de práctica clínica no han considerado buena parte de la evidencia existente, aunque sus recomendaciones son concordantes con este resumen. |
| Databáze: | OpenAIRE |
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