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. 1982 Jan;23(1):75–79. doi: 10.1136/gut.23.1.75

Controlled trial of methylprednisolone therapy in severe acute alcoholic hepatitis.

A Theodossi, A L Eddleston, R Williams
PMCID: PMC1419581  PMID: 7035299

Abstract

The efficacy of methylprednisolone (1 g daily or three days), which is effective in reversing transplant rejection, was assessed in a randomised controlled trial of 55 patients with severe acute alcoholic hepatitis, 34 of whom had encephalopathy. The clinical progress, frequency of bleeding and sepsis, and cause of death were similar in the treatment (27 patients) and control groups (28 patients). There was no significant difference in mortality rate between the two groups: 57% of the control group and 63% of the treatment group died during the study. Patients' survival depended on the presence of absence of the following features: encephalopathy, serum bilirubin concentration more than 340 micromol/l, serum creatinine concentration more than 250 micromol/l, and histological evidence of cirrhosis as well as severe acute alcoholic hepatitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BECKETT A. G., LIVINGSTONE A. V., HILL K. R. Acute alcoholic hepatitis. Br Med J. 1961 Oct 28;2(5260):1113–1119. doi: 10.1136/bmj.2.5260.1113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bailey R. J., Krasner N., Eddleston A. L., Williams R., Tee D. E., Doniach D., Kennedy L. A., Batchelor J. R. Histocompatibility antigens, autoantibodies, and immunoglobulins in alcoholic liver disease. Br Med J. 1976 Sep 25;2(6038):727–729. doi: 10.1136/bmj.2.6038.727. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Balow J. E., Hunninghake G. W., Fauci A. S. Corticosteroids in human lymphocyte-mediated cytotoxic reactions: effects on the kinetics of sensitization and on the cytolytic capacity of effector lymphocytes in vitro. Transplantation. 1977 Apr;23(4):322–328. [PubMed] [Google Scholar]
  4. Blitzer B. L., Mutchnick M. G., Joshi P. H., Phillips M. M., Fessel J. M., Conn H. O. Adrenocorticosteroid therapy in alcoholic hepatitis. A prospective, double-blind randomized study. Am J Dig Dis. 1977 Jun;22(6):477–484. doi: 10.1007/BF01072499. [DOI] [PubMed] [Google Scholar]
  5. Campra J. L., Hamlin E. M., Jr, Kirshbaum R. J., Olivier M., Redeker A. G., Reynolds T. B. Prednisone therapy of acute alcoholic hepatitis. Report of a controlled trial. Ann Intern Med. 1973 Nov;79(5):625–631. doi: 10.7326/0003-4819-79-5-625. [DOI] [PubMed] [Google Scholar]
  6. Conn H. O. Steroid treatment of alcoholic hepatitis. The yeas and the nays. Gastroenterology. 1978 Feb;74(2 Pt 1):319–322. [PubMed] [Google Scholar]
  7. Davidson C. S. Alcoholic hepatitis. N Engl J Med. 1971 Jun 17;284(24):1378–1378. doi: 10.1056/NEJM197106172842411. [DOI] [PubMed] [Google Scholar]
  8. Depew W., Boyer T., Omata M., Redeker A., Reynolds T. Double-blind controlled trial of prednisolone therapy in patients with severe acute alcoholic hepatitis and spontaneous encephalopathy. Gastroenterology. 1980 Mar;78(3):524–529. [PubMed] [Google Scholar]
  9. EDMONDSON H. A., PETERS R. L., REYNOLDS T. B., KUZMA O. T. SCLEROSING HYALINE NECROSIS OF THE LIVER IN THE CHRONIC ALCOHOLIC. A RECOGNIZABLE CLINICAL SYNDROME. Ann Intern Med. 1963 Nov;59:646–673. doi: 10.7326/0003-4819-59-5-646. [DOI] [PubMed] [Google Scholar]
  10. Elashoff J. D. Combining results of clinical trials. Gastroenterology. 1978 Dec;75(6):1170–1172. [PubMed] [Google Scholar]
  11. Gordon R. S., Jr Type II error in clinical trials. Gastroenterology. 1980 Jul;79(1):180–180. [PubMed] [Google Scholar]
  12. Hardison W. G., Lee F. I. Prognosis in acute liver disease of the alcoholic patient. N Engl J Med. 1966 Jul 14;275(2):61–66. doi: 10.1056/NEJM196607142750201. [DOI] [PubMed] [Google Scholar]
  13. Harinasuta U., Zimmerman H. J. Alcoholic steatonecrosis. I. Relationship between severity of hepatic disease and presence of Mallory bodies in the liver. Gastroenterology. 1971 Jun;60(6):1036–1046. [PubMed] [Google Scholar]
  14. Helman R. A., Temko M. H., Nye S. W., Fallon H. J. Alcoholic hepatitis. Natural history and evaluation of prednisolone therapy. Ann Intern Med. 1971 Mar;74(3):311–321. doi: 10.7326/0003-4819-74-3-311. [DOI] [PubMed] [Google Scholar]
  15. Kanagasundaram N., Kakumu S., Chen T., Leevy C. M. Alcoholic hyalin antigen (AHAg) and antibody (AHAb) in alcoholic hepatitis. Gastroenterology. 1977 Dec;73(6):1368–1373. [PubMed] [Google Scholar]
  16. Lesesne H. R., Bozymski E. M., Fallon H. J. Treatment of alcoholic hepatitis with encephalopathy. Comparison of prednisolone with caloric supplements. Gastroenterology. 1978 Feb;74(2 Pt 1):169–173. [PubMed] [Google Scholar]
  17. Maddrey W. C., Boitnott J. K., Bedine M. S., Weber F. L., Jr, Mezey E., White R. I., Jr Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978 Aug;75(2):193–199. [PubMed] [Google Scholar]
  18. Mikkelsen W. P., Turrill F. L., Kern W. H. Acute hyaline necrosis of the liver. A surgical trap. Am J Surg. 1968 Aug;116(2):266–272. doi: 10.1016/0002-9610(68)90503-5. [DOI] [PubMed] [Google Scholar]
  19. Schlichting P., Juhl E., Poulsen H., Winkel P. Alcoholic hepatitis superimposed on cirrhosis. Clinical significance and effect of long-term prednisone treatment. Scand J Gastroenterol. 1976;11(3):305–312. [PubMed] [Google Scholar]
  20. Shumaker J. B., Resnick R. H., Galambos J. T., Makopour H., Iber F. L. A controlled trial of 6-methylprednisolone in acute alcoholic hepatitis. With a note on published results in encephalopathic patients. Am J Gastroenterol. 1978 Apr;69(4):443–449. [PubMed] [Google Scholar]

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