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People who survive an episode of severe alcoholic hepatitis should be advised to maintain total abstinence from alcohol
Author(s) -
Atkinson Stephen R.,
McQuillin Andrew,
Morgan Marsha Y.,
Thursz Mark R.
Publication year - 2018
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.29825
Subject(s) - medicine , abstinence , alcoholic hepatitis , hazard ratio , hepatology , placebo , confidence interval , prednisolone , hepatitis c , alcoholic liver disease , psychiatry , alternative medicine , cirrhosis , pathology
We read with interest the article published in HEPATOLOGY by Louvet et al. highlighting factors influencing outcomes in people with severe alcoholic hepatitis. They found that beyond 6 months, alcohol relapse, defined as consumption of 30 g/day, was an independent predictor of mortality with a dose-related effect on the hazard ratio (HR). The effect of drinking behavior on outcome has also been examined in data collected in the Steroids and Pentoxyfylline for Severe Alcoholic Hepatitis (STOPAH) trial. Patients were classified, in the original published analysis, as abstinent or drinking. A return to alcohol consumption at day 90 was associated with a significantly higher mortality at day 450 than abstinence (HR, 2.77; 95% confidence interval [CI], 1.79-4.29; P < 0.00001). We have reexamined these data in an attempt to replicate the dose-