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Glucocorticosteroids for people with alcoholic hepatitis
Chavdar S Pavlov1, Daria L Varganova, Giovanni Casazza
1The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark, DK-2100.
The Cochrane Database of Systematic Reviews
|November 3, 2017
Summary
Glucocorticosteroids show no significant benefit for alcoholic hepatitis patients. High risk of bias and low-quality evidence mean results are uncertain, necessitating further research.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Evidence-Based Medicine
Background:
- Alcoholic hepatitis is a severe form of alcoholic liver disease.
- It is characterized by inflammation and liver cell damage.
- Glucocorticosteroids are commonly used to manage inflammation in alcoholic hepatitis.
Purpose of the Study:
- To evaluate the benefits and harms of glucocorticosteroids in treating alcoholic hepatitis.
- To synthesize evidence from randomized clinical trials on glucocorticosteroid efficacy.
Main Methods:
- Systematic review and meta-analysis of 16 randomized clinical trials.
- Included trials compared glucocorticosteroids with placebo or no intervention.
- Data analyzed using traditional and Trial Sequential Analysis methods.
Main Results:
- No evidence of glucocorticosteroid effectiveness on all-cause mortality, quality of life, or serious adverse events.
- All included trials had a high risk of bias.
- Quality of evidence was rated as very low or low.
Conclusions:
- Current evidence is insufficient to support or refute the use of glucocorticosteroids for alcoholic hepatitis.
- High risk of bias and low-quality evidence lead to uncertainty about treatment effects.
- Further high-quality, placebo-controlled trials are needed to clarify benefits and harms.
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