Alcoholic Hepatitis

Treatment of ETOH Hepatitis

Deciding to Treat

We mainly use the the Maddrey discriminant function (DF) which is an objective measure based on the INR, bilirubin, etc. Maddrey DF ≥ 32 indicates severe ETOH hepatitis with high mortality risk and would likely benefit from specific treatment.

Treatment Regimens

Picking a Regimen

The STOPAH trial (2015) compared prednisolone, pentoxyfylline, or a combination of both in the treatment of alcoholic hepatitis, and looked at 28-day mortality as a primary outcome.

Prednisolone

Contraindications to prednisolone treatment: active proven or suspected infection.

Pentoxyfylline

Response to Treatment

We mainly use the Lille score which is derived from changes in bilirubin in response to steroid treatment of ETOH hepatitis.