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Pentoxifylline is ineffective in treating severe alcoholic hepatitis
  1. Philip Hendy

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Philip Hendy reviews Thursz et al.1The randomized double blind placebo controlled Steroids or Pentoxifylline for Alcoholic Hepatitis (STOPAH) trial demonstrates that pentoxifylline does not improve mortality in severe alcoholic hepatitis at 28 days or beyond. It also demonstrates that prednisolone provides a non-significant mortality benefit at 28 days which does not persist to 90 days or beyond and is associated with increased risk of infection.

Alcoholic hepatitis is a syndrome characterised by jaundice and liver dysfunction in the setting of significant long-term alcohol excess. Severe disease is associated with high mortality—30% at 1 month and 40% at 6 months.2 ,3 Treatment consists of organ support as required, as well as steroid and or pentoxifylline (PTX) therapy, both of which are included in national and international management guidelines. The European Association for the Study of the Liver guidelines include steroids and, in the case of ongoing sepsis, PTX.4 …

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