Medical Therapies for Improving Short-Term Survival in Severe Alcoholic Hepatitis

Medical therapies for severe alcoholic hepatitis such as corticosteroids (CS), pentoxifylline (PTX), and N-acetylcysteine (NAC), both alone and in combination, have shown variable success in improving survival. Results of a recent large, randomized trial showed a marginal improvement in 28-day survival with CS but no long-term survival benefit with either CS or PTX (NEJM JW Gastroenterol Jun 2015 and N Engl J Med 2015; 372:1619).

In the current systematic review and network meta-analysis of 22 randomized, controlled trials comprising 2621 patients, researchers compared the efficacy of CS, PTX, and NAC for improving 28-day survival in patients with severe alcoholic hepatitis (Maddrey discriminant function ≥32, hepatic encephalopathy, or both)…