Prednisolone, Pentoxifylline Little Use in Alcoholic Hepatitis
Nonsignificant drop in 28-day mortality with prednisolone; no improvement with pentoxifylline
THURSDAY, April 23, 2015 (HealthDay News) -- Prednisolone and pentoxifylline are associated with limited and no benefits, respectively, for severe alcoholic hepatitis, according to a study published in the April 23 issue of the The New England Journal of Medicine.
Mark R. Thursz, M.D., from Imperial College London, and colleagues examined the effect of treatment with prednisolone or pentoxifylline for severe alcoholic hepatitis. Patients were randomized to pentoxifylline-matched placebo and a prednisolone-matched placebo, prednisolone and a pentoxifylline-matched placebo, pentoxifylline and a prednisolone-matched placebo, or prednisolone and pentoxifylline. Data were available for 1,053 patients who underwent randomization.
The researchers found that 28-day mortality was 17 percent in the placebo-placebo group, 14 percent in the prednisolone-placebo group, 19 percent in the pentoxifylline-placebo group, and 13 percent in the prednisolone-pentoxifylline group. For 28-day mortality, the odds ratio was 1.07 (95 percent confidence interval, 0.77 to 1.49; P = 0.69) for pentoxifylline and 0.72 (95 percent confidence interval, 0.52 to 1.01; P = 0.06) for prednisolone. No significant between-group differences were seen at 90 days and one year.
"Pentoxifylline did not improve survival in patients with alcoholic hepatitis," the authors write. "Prednisolone was associated with a reduction in 28-day mortality that did not reach significance and with no improvement in outcomes at 90 days or one year."
Two authors disclosed financial ties to the pharmaceutical industry.