Corticosteroid therapy of alcoholic hepatitis

Willis C. Maddrey, John K. Boitnott, Marshall S. Bedine, Fredrick L. Weber, Esteban Mezey, Robert I. White

Research output: Contribution to journalArticle

611 Scopus citations

Abstract

Fifty-five patients with alcoholic hepatitis were studied in a 28- to 32-day randomized double blind treatment trial comparing prednisolone (40 mg per day) with placebo therapy. Of 31 placebo-treated patients, 4 died during the study interval and 2 more died within 5 days of study completion. Only 1 of 24 prednisolone-treated patients died during the same interval (Fisher exact test; P = 0.10). Stepwise discriminant analysis of laboratory factors associated with death revealed independently significant associations with prolongation of prothrombin time and height of serum bilirubin at the initiation of the study. When treatment was included as a variable in this discriminant analysis, it was found that corticosteroid therapy significantly decreased mortality (P < 0.05). The corrected wedged hepatic venous pressure decreased to a similar extent in the two groups. These studies suggest that corticosteroid therapy does decrease early mortality in patients with severe alcoholic hepatitis, but has no short term effect on the development of portal hypertension.

Original languageEnglish (US)
Pages (from-to)193-199
Number of pages7
JournalGastroenterology
Volume75
Issue number2
DOIs
StatePublished - Aug 1978

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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