The clinical effectiveness and cost-effectiveness of STeroids Or Pentoxifylline for Alcoholic Hepatitis (STOPAH): a 2 × 2 factorial randomised controlled trial

Thursz M, Forrest E, Roderick P, Day C, Austin A, O'Grady J, Ryder S, Allison M, Gleeson D, McCune A, Patch D, Wright M, Masson S, Richardson P, Vale L, Mellor J, Stanton L, Bowers M, Ratcliffe I, Downs N, Kirkman S, Homer T, Ternent L
Record ID 32010000398
English
Authors' objectives: The aim of the clinical effectiveness and cost-effectiveness of STeroids Or Pentoxifylline for Alcoholic Hepatitis trial was to resolve the clinical dilemma on the use of prednisolone or pentoxifylline (PTX). Alcoholic hepatitis (AH) is a distinct presentation of alcoholic liver disease arising in patients who have been drinking to excess for prolonged periods, which is characterised by jaundice and liver failure. Severe disease is associated with high short-term mortality. Prednisolone and PTX are recommended in guidelines for treatment of severe AH, but trials supporting their use have given heterogeneous results and controversy persists about their benefit.
Authors' recommendations: We conclude that prednisolone reduces the risk of mortality at 28 days, but this benefit is not sustained beyond 28 days. PTX had no impact on survival. Future research should focus on interventions to promote abstinence and on treatments that suppress the hepatic inflammation without increasing susceptibility to infection.
Details
Project Status: Completed
URL for project: http://www.nets.nihr.ac.uk/projects/hta/081444
Year Published: 2015
URL for published report: http://www.journalslibrary.nihr.ac.uk/hta/hta191020/#/abstract
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Pentoxifylline
  • Steroids
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: <p>2010 Queen's Printer and Controller of HMSO</p>
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