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Propylthiouracil for alcoholic liver disease.
1Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, H:S Rigshopitalet, Blegdamsvej 9, Copenhagen, Denmark, DK-2100. arambaldi@hotmail.com
The Cochrane Database of Systematic Reviews
|June 22, 2002
Summary
Propylthiouracil (PTU) showed no significant benefit for alcoholic liver disease outcomes in a systematic review of randomized trials. PTU was associated with adverse events, indicating no evidence for its use outside clinical trials.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Evidence-Based Medicine
Background:
- Alcoholic liver disease (ALD) is a leading cause of liver pathology in Western countries.
- Randomized clinical trials (RCTs) have investigated propylthiouracil (PTU) for ALD treatment.
Purpose of the Study:
- To systematically evaluate the efficacy of PTU in patients with ALD.
- Assess PTU's impact on mortality, clinical symptoms, liver biochemistry, histology, and adverse events.
Main Methods:
- Comprehensive literature search of multiple databases (Cochrane, MEDLINE, EMBASE) and full-text searches.
- Inclusion of RCTs of PTU versus placebo in patients with various stages of ALD.
- Intention-to-treat analysis and assessment of trial quality using Jadad-scale.
Main Results:
- Six RCTs with 710 patients found no significant effect of PTU on mortality, liver-related mortality, or liver histology.
- PTU did not significantly improve liver disease complications but showed a trend towards increased non-serious adverse events and rare serious events like leukopenia.
Conclusions:
- This systematic review found no significant clinical benefits of PTU for alcoholic liver disease.
- PTU is associated with adverse events, and there is no evidence to support its use in ALD outside of controlled clinical trials.