Corticosteroids in severe alcohol-related hepatitis: A multicenter randomized clinical trial.
Christophe Moreno, Pierre Deltenre, Astrid Marot et al.
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In 30 seconds
This multicenter randomized controlled trial evaluated the effect of corticosteroid therapy on survival in patients with severe alcohol-related hepatitis (AH) showing early spontaneous bilirubin improvement. Among 69 patients, 90-day survival was 79% in the corticosteroid group compared to 83% in the placebo group (hazard ratio 1.19, p = 0.76), indicating no significant survival benefit from corticosteroids.
Key findings
- 90-day survival was 79% in the corticosteroid group vs. 83% in the placebo group (p = 0.76).
- 30-day survival rates were 95% for corticosteroids and 94% for placebo (p = 0.83).
- Cumulative incidence of infection at 90 days was 47% in the corticosteroid group vs. 34% in the placebo group (p = 0.26).
- The trial was underpowered, analyzing only 69 of the planned 140 patients.
Why it matters
The findings suggest that corticosteroid therapy may not improve survival in patients with severe AH who show early bilirubin improvement, highlighting the need for careful patient selection and monitoring. This could influence treatment strategies and risk assessment in clinical practice.
What to keep in mind
The trial was underpowered, having enrolled only 69 of the planned 140 patients, limiting the ability to draw definitive conclusions.