Where Are We with Pentoxifylline for Severe Alcoholic Hepatitis?

Acute alcoholic hepatitis (AH) is associated with high rates of morbidity and mortality. The commonly recommended treatment is corticosteroids, which have been shown to improve short-term survival but have substantial adverse effects, such as infection and sepsis. Pentoxifylline (PTX), an oral anti–tumor necrosis factor agent, has also been used in reducing hepatorenal syndrome (HRS) and mortality in AH and is recommended when infection precludes corticosteroid use. However, evidence of its efficacy is based on only a small number of studies. The current systematic review incorporates the largest number of trials to date evaluating the efficacy of PTX in severe AH.

Investigators identified abstracts and articles of randomized, controlled tri…