Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Apr 7;15(13):1613-9.
doi: 10.3748/wjg.15.1613.

Pentoxifylline versus prednisolone for severe alcoholic hepatitis: a randomized controlled trial

Binay Krishna De  1 , Subhabrata Gangopadhyay, Deep Dutta, Sumanta Das Baksi, Adyapad Pani, Pramit Ghosh
Affiliations
Randomized Controlled Trial

Pentoxifylline versus prednisolone for severe alcoholic hepatitis: a randomized controlled trial

Binay Krishna De et al. World J Gastroenterol. .

Abstract

Aim: To compare the efficacy of pentoxifylline and prednisolone in the treatment of severe alcoholic hepatitis, and to evaluate the role of different liver function scores in predicting prognosis.

Methods: Sixty-eight patients with severe alcoholic hepatitis (Maddrey score > or = 32) received pentoxifylline (n = 34, group I) or prednisolone (n = 34, group II) for 28 d in a randomized double-blind controlled study, and subsequently in an open study (with a tapering dose of prednisolone) for a total of 3 mo, and were followed up over a period of 12 mo.

Results: Twelve patients in group II died at the end of 3 mo in contrast to five patients in group I. The probability of dying at the end of 3 mo was higher in group II as compared to group I (35.29% vs 14.71%, P = 0.04; log rank test). Six patients in group II developed hepatorenal syndrome as compared to none in group I. Pentoxifylline was associated with a significantly lower model for end-stage liver disease (MELD) score at the end of 28 d of therapy (15.53 +/- 3.63 vs 17.78 +/- 4.56, P = 0.04). Higher baseline Maddrey score was associated with increased mortality.

Conclusion: Reduced mortality, improved risk-benefit profile and renoprotective effects of pentoxifylline compared with prednisolone suggest that pentoxifylline is superior to prednisolone for treatment of severe alcoholic hepatitis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Survival curves (Kaplan-Meier life table analysis) of patients receiving pentoxifylline (group I) as compared to patients receiving prednisolone (group II), at the end of 3 mo of therapy.
Figure 2
Figure 2
Summary of trial design and follow-up.
See this image and copyright information in PMC

Comment in

References

    1. Lefkowitch JH. Morphology of alcoholic liver disease. Clin Liver Dis. 2005;9:37–53. - PubMed
    1. Teli MR, Day CP, Burt AD, Bennett MK, James OF. Determinants of progression to cirrhosis or fibrosis in pure alcoholic fatty liver. Lancet. 1995;346:987–990. - PubMed
    1. Perrot S, Beaugrand M. [Treatment of alcoholic hepatitis. A review of randomized trials] Gastroenterol Clin Biol. 1988;12:521–531. - PubMed
    1. Stewart S, Jones D, Day CP. Alcoholic liver disease: new insights into mechanisms and preventative strategies. Trends Mol Med. 2001;7:408–413. - PubMed
    1. Zhang T, Li Y, Lai JP, Douglas SD, Metzger DS, O'Brien CP, Ho WZ. Alcohol potentiates hepatitis C virus replicon expression. Hepatology. 2003;38:57–65. - PubMed

Publication types