How Quickly Can You Discontinue Steroid Therapy in Severe Alcoholic Hepatitis?

The Lille Model, applied at day 4 of corticosteroid therapy, was a strong independent predictor of 28-day and 90-day mortality in a retrospective study.

Studies of patients with severe alcoholic hepatitis (AH) have shown an overall mortality benefit of short-term corticosteroid therapy (NEJM JW Gastroenterol Nov 2013 and JAMA 2013; 310:1033). The validated Lille Model is used to determine whether these patients should continue such therapy. In a multinational retrospective study of 260 patients with severe AH and a Maddrey's discriminant function (DF) ≥32, researchers assessed whether for the 163 patients who had been treated with corticosteroid therapy (median Maddrey's DF, 64) the Lille Model was useful when applied at 4 days (LM4) and at 7 days (LM7) after therapy initiation.

The 90-day mortality rate among corticosteroid-treated patients was 36%. All prognostic criteria — LM4, LM7, the M…

Reviewing Author

Atif Zaman, MD, MPH

Disclosures

Nothing to disclose

Atif Zaman, MD, MPH

Disclosures

Nothing to disclose

How Quickly Can You Discontinue Steroid Therapy in Severe Alcoholic Hepatitis?

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Reviewing Author