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
Review
. 2024 Mar;59(6):730-741.
doi: 10.1111/apt.17888. Epub 2024 Feb 1.

Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis

Wen Hui Lim  1 , Phoebe Tay  1 , Cheng Han Ng  2 , Darren Jun Hao Tan  1 , Christen Ong  1 , Jia Hong Koh  1   2   3 , Margaret Teng  1   2   3 , Douglas Chee  2 , Zhen Yu Wong  4 , Takumi Kawaguchi  5 , Hirokazu Takahashi  6 , Mark Muthiah  1   2   3 , Eunice X X Tan  1   2   3 , Karn Wijarnpreecha  7 , Guan Huei Lee  1   2   3 , Mazen Noureddin  8 , Brian P Lee  9 , Philippe Mathurin  10 , Rohit Loomba  11   12 , Daniel Q Huang  1   2   3   11
Affiliations
Review

Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis

Wen Hui Lim et al. Aliment Pharmacol Ther. 2024 Mar.

Abstract

Background: Although alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified.

Aims: To determine the prevalence of alcohol abstinence, factors associated with alcohol abstinence and the impact of abstinence on morbidity and overall survival in people with alcohol-associated cirrhosis.

Methods: We searched Medline and Embase from inception to 15 April 2023 for prospective and retrospective cohort studies describing alcohol abstinence in people with known alcohol-associated cirrhosis. Meta-analysis of proportions for pooled estimates was performed. The method of inverse variance, employing a random-effects model, was used to pool the hazard ratio (HR) comparing outcomes of abstinent against non-abstinent individuals with alcohol-associated cirrhosis.

Results: We included 19 studies involving 18,833 people with alcohol-associated cirrhosis. The prevalence of alcohol abstinence was 53.8% (CI: 44.6%-62.7%). Over a mean follow-up duration of 48.6 months, individuals who continued to consume alcohol had significantly lower overall survival compared to those who were abstinent (HR: 0.611, 95% CI: 0.506-0.738). These findings remained consistent in sensitivity/subgroup analysis for the presence of decompensation, study design and studies that assessed abstinence throughout follow-up. Alcohol abstinence was associated with a significantly lower risk of hepatic decompensation (HR: 0.612, 95% CI: 0.473-0.792).

Conclusions: Alcohol abstinence is associated with substantial improvement in overall survival in alcohol-associated cirrhosis. However, only half of the individuals with known alcohol-associated cirrhosis are abstinent.

Keywords: abstinence; cirrhosis; hepatocellular carcinoma; prevalence; survival.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

Cheng Han Ng: CHN serves as a consultant to Boxer Capital. Brian P Lee: BPL receives Siemens Healthineers Consulting fees from GlaxoSmithKline. Philippe Mathurin: PM serves as a consultant for Abbvie, Advanz Pharma Services, Agomab Therapeutics, Astra Zenneca, Bayer Healthcare, Eisai, Evive Biotech, Gilead Sciences, GlaxoSmithKline, Iddi, Intercept, Ipsen, Novo Nordisk, Pfizer, Resolution Therapeutics, Roche, Surrozen. Rohit Loomba: RL serves as a consultant to Aardvark Therapeutics, Altimmune, Arrowhead Pharmaceuticals, AstraZeneca, Cascade Pharmaceuticals, Eli Lilly, Gilead, Glympse bio, Inipharma, Intercept, Inventiva, Ionis, Janssen Inc., Lipidio, Madrigal, Neurobo, Novo Nordisk, Merck, Pfizer, Sagimet, 89 bio, Takeda, Terns Pharmaceuticals and Viking Therapeutics. In addition, his institution received research grants from Arrowhead Pharmaceuticals, Astrazeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Eli Lilly, Galectin Therapeutics, Gilead, Intercept, Hanmi, Intercept, Inventiva, Ionis, Janssen, Madrigal Pharmaceuticals, Merck, Novo Nordisk, Pfizer, Sonic Incytes and Terns Pharmaceuticals. Co-founder of LipoNexus Inc. Daniel Q. Huang: DQH has served as a consultant for Gilead Sciences.

Figures

F I G U R E 1
F I G U R E 1
PRISMA flow diagram.
F I G U R E 2
F I G U R E 2
Pooled overall survival of non-abstinent vs abstinent individuals with known alcohol-associated cirrhosis. Pooled hazard ratio (95% CI): 0.61 [0.51–0.74], Using random-effects model. I2: 77.4%.
See this image and copyright information in PMC

References

    1. Lee BP, Vittinghoff E, Dodge JL, Cullaro G, Terrault NA. National Trends and long-term outcomes of liver transplant for alcohol-associated liver disease in the United States. JAMA Intern Med. 2019;179(3):340–8. - PMC - PubMed
    1. Ventura-Cots M, Argemi J, Jones PD, Lackner C, el Hag M, Abraldes JG, et al. Clinical, histological and molecular profiling of different stages of alcohol-related liver disease. Gut. 2022;71(9):1856–66. - PMC - PubMed
    1. Singal AK, Mathurin P. Diagnosis and treatment of alcohol-associated liver disease: a review. JAMA. 2021;326(2):165–76. - PubMed
    1. Bataller R, Arab JP, Shah VH. Alcohol-associated hepatitis. N Engl J Med. 2022;387(26):2436–48. - PubMed
    1. Tapper EB, Parikh ND. Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study. BMJ. 2018;362:2817. - PMC - PubMed