[Is pentoxifylline effective in alcoholic hepatitis?].

Abstract

QUESTION:

Steroidal therapy benefits patients with severe alcoholic hepatitis. However, steroid use is associated with severe side effects like infections and possibly, upper gastrointestinal bleeding. Pentoxifyllin, an inhibitor of Tumor Necrosis Factor has fewer side effects, but its effectiveness is not clear, nor its potential benefits as an adjunctive therapy to steroids.

METHODS:

We used Epistemonikos database, which is mantained through searches in 19 databases, to find systematic reviews and their included primary studies. A structured summary was created using a predefined format that includes key messages, a summary of the body of evidence (presented as a matrix of evidence in Epistemonikos), and a summary of findings table using the GRADE approach, along with other factors that aid decision-making.

KEY MESSAGES:

Pentoxifyllin probably reduces mortality when compared with placebo. Pentoxifyllin could be less effective than steroid therapy for reducing mortality. Addition of pentoxifyllin to steroid therapy does not reduce mortality. Most practice guidelines have not taken into account an important portion of the existing evidence, even though their recommendations are in accordance with the present review.

• Authors: Gabriel Rada, Matías Arteaga
• Journal: Medwave (Medwave) Vol. 14 Issue 6 Pg. e6002 (Jul 29 2014) ISSN: 0717-6384 [Electronic] Chile
• Vernacular Title: ¿Es efectiva la pentoxifilina en hepatitis alcohólica?
• PMID: 25353639 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Glucocorticoids
• Phosphodiesterase Inhibitors
• Tumor Necrosis Factor-alpha
• Pentoxifylline

Topics

• Glucocorticoids (adverse effects, therapeutic use)
• Hepatitis, Alcoholic (drug therapy, mortality)
• Humans
• Pentoxifylline (adverse effects, pharmacology, therapeutic use)
• Phosphodiesterase Inhibitors (adverse effects, pharmacology, therapeutic use)
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)