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[Acute alcoholic hepatitis: treatments].
1Service d'Hépato-Gastroentérologie, Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, F 92141 Clamart. sylvie.naveau@abc.ap-hop-paris.fr
Presse Medicale (Paris, France : 1983)
|July 4, 2001
Summary
Acute alcoholic hepatitis (AAH) is a severe liver disease with high mortality. Corticosteroids are the gold standard treatment for severe AAH, improving short-term survival, but new therapies are needed.
Area of Science:
- Hepatology and Gastroenterology
- Alcohol-Related Liver Disease Research
- Clinical Trial Analysis
Context:
- Acute alcoholic hepatitis (AAH) presents a significant short-term mortality risk, potentially reaching 50%.
- Long-term prognosis is contingent upon sustained alcohol abstinence and the progression to cirrhosis.
- Effective management strategies for AAH are critical due to its severity.
Purpose:
- To review and evaluate various therapeutic strategies for acute alcoholic hepatitis (AAH).
- To identify the most effective treatments based on existing clinical trial data.
- To establish the current gold standard of care and explore future therapeutic directions.
Summary:
- Abstinence from alcohol is the primary and essential therapeutic measure for AAH.
- Numerous drug treatments and nutritional support strategies have been investigated, including anti-inflammatory agents, hepatoprotective compounds, and nutritional interventions.
- Corticosteroid therapy is the only strategy with proven efficacy, particularly for severe AAH (Maddrey index ≥ 32), with oral prednisolone as the gold standard.
Impact:
- Corticosteroid therapy improves short-term survival in severe AAH, though mortality remains substantial (around 30% at 2 months).
- The findings underscore the need for continued research into novel treatments, with anti-TNF alpha antibodies showing promise.
- This evidence base guides clinical practice and highlights areas for future therapeutic development in AAH.