2012, Number 3
Med Int Mex 2012; 28 (3)
Garrido GJR, Sánchez HG, Melchor LA, Elizalde BCI, Sánchez VL
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ABSTRACTBackground: Alcoholic hepatitis (AH) severe is a cholestatic liver disease, with high mortality rate. The main factor involved in the genesis is the Tumor Necrosis Factor-alpha (TNF-α). There are no conclusive studies that support what is the best treatment using either PTX or corticosteroids. Objective: To compare the short-term survival in AH severe, using PTX or corticosteroids.
Material and methods: Sixty patients with AH severe (Maddrey score ›32) received PTX (n = 30) or prednisone [PDN] (n = 30) for 28 days, in a randomized controlled clinical study. The primary endpoint of the study was the effect of PTX in the short-term survival compared with corticosteroid. Secondary point was the appearance and development of hepatorenal syndrome with the use of PTX.
Results: Fourteen patients in the PTX group and 18 patients in the PDN group died (46.66 vs. 59.99%, p = 0.30). Thirteen patients in the PDN group developed SHR, compared with 6 patients in the PTX group (RR 0.53; IC 95%: 0.04-0.35, p = 0.05,).
Conclusions: No difference was found in both treatment groups in the short-term survival in the severe AH. The PTX decreased the risk of developing SHR. There were not other variables related to survival by treatment group.