Pharmacotherapy of acute alcoholic hepatitis in clinical practice

World J Gastroenterol. 2014 Mar 7;20(9):2159-67. doi: 10.3748/wjg.v20.i9.2159.

Abstract

Severe alcoholic hepatitis (AH) is an acute form of alcohol induced liver disease with a poor prognosis that is seen in the patients who consume large quantities of alcohol. The diagnosis of AH is based on the appropriate alcohol intake history and is supported with clinical and histological features, and several scoring systems. Glucocorticoids are the mainstay for treating severe AH with pentoxifylline used as an alternative to steroids in addition to total alcohol abstinence. Liver transplantation is a possible therapeutic option for severe AH. Among the anti-craving medications able to improve abstinence rate, baclofen seems to be effective and safe in the alcoholic patients affected by severe liver damage.

Keywords: Alcoholic liver disease; Baclofen; Glucocorticoids; Maddrey’s discriminant function; Orthotopic liver transplantation; Severe alcoholic hepatitis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Alcohol Abstinence
  • Alcohol Deterrents / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use*
  • Antioxidants / therapeutic use*
  • Dietary Supplements
  • Glucocorticoids / therapeutic use*
  • Hepatitis, Alcoholic / diagnosis
  • Hepatitis, Alcoholic / drug therapy*
  • Hepatitis, Alcoholic / immunology
  • Humans
  • Liver Transplantation
  • Phosphodiesterase Inhibitors / therapeutic use*
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Alcohol Deterrents
  • Anti-Inflammatory Agents
  • Antioxidants
  • Glucocorticoids
  • Phosphodiesterase Inhibitors
  • Tumor Necrosis Factor-alpha