17 April 2010
Washington, DC
Two French studies have shed new light on the treatment options for patients suffering from severe alcoholic hepatitis.
The first research showed the positive potential of performing liver transplantation for patients suffering from severe alcoholic hepatitis (SAH) earlier than the recommended 6–months rule (required minimum of recorded abstinence for an alcoholic patient to be eligible for a liver transplant).
Indeed, those patients who do not respond to treatment with steroids have a 6–month survival of around 30% and most deaths actually occur within 2–months.
The results demonstrate that early liver transplantation could be proposed to non–respondents, pending a very careful evaluation of selected patients.
Acute alcoholic hepatitis (AAH) however, is an absolute contraindication for liver transplantation.
It has a low survival rate, with mortality remaining at around 35% at 6 months despite corticoid treatment, the current standard of care for the condition.
The second study will help inform a potential new treatment option for those patients who do not respond to standard treatment with corticoid.
Data demonstrated that treatment with combined corticoids plus N–acetyl cysteine (C+NAC) showed an increase in survival rates.
There have been few, large, well–designed trials advocating the use of N–acetyl cysteine to slow progression of liver disease.
This latest research adds to the growing body of evidence in the benefits of treatment with C+NAC in patients with acute liver disease.
“Whilst the management of alcoholic hepatitis is steeped in controversy, as clinicians we have a responsibility to treat these patients in the most effective way possible, and as researchers we have a mandate to highlight new options,” Philippe Mathurin, from the Hôpital Huriez, CHRU Lille, France said.
Mathurin added: "These latest results across large patient cohorts are the sort of clinical studies that are vital to help guide best practice in the treatment pathway for difficult–to–treat patients with a challenging medical history. Alongside education and, ideally, prevention strategies we can achieve some successful outcomes."
The findings of the two studies were presented at the International Liver CongressTM 2010 press conference.
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