2018
DOI: 10.1016/j.cgh.2018.01.040
|View full text |Cite
|
Sign up to set email alerts
|

Efficacy of Granulocyte Colony-Stimulating Factor and N-Acetylcysteine Therapies in Patients With Severe Alcoholic Hepatitis

Abstract: In a pilot randomized controlled trial, we found administration of G-CSF to improve liver function and increase survival times in patients with severe AH, compared with standard therapy. We found no evidence for benefit of adding NAC to G-CSF. These findings require confirmation in larger trials. ClincialTrials.gov, number: NCT02971306.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
2
2
1

Citation Types

1
100
0
1

Year Published

2018
2018
2023
2023

Publication Types

Select...
5
2

Relationship

0
7

Authors

Journals

citations
Cited by 86 publications
(102 citation statements)
references
References 24 publications
1
100
0
1
Order By: Relevance
“…To investigate the effect of study design, an additional comparison of mortality proportions was made between prospective and retrospective studies. Studies conducted in patients with severe alcoholic hepatitis from non‐Caucasian populations have reported high mortality of over 50% at 90 days . Therefore, a subgroup analysis to determine the influence of ethnicity on mortality proportion was performed.…”
Section: Methodsmentioning
confidence: 99%
“…To investigate the effect of study design, an additional comparison of mortality proportions was made between prospective and retrospective studies. Studies conducted in patients with severe alcoholic hepatitis from non‐Caucasian populations have reported high mortality of over 50% at 90 days . Therefore, a subgroup analysis to determine the influence of ethnicity on mortality proportion was performed.…”
Section: Methodsmentioning
confidence: 99%
“…Society guidelines strongly recommend with moderate supporting evidence the use of steroids in SAH, conditionally recommend with low supporting evidence against the use of pentoxifylline in SAH, and conditionally recommend with very low supporting evidence nutritional supplementation for AH . The guidelines recognize that therapies with potential efficacy for AH may include N ‐acetyl cysteine (NAC) and granulocyte colony–stimulating factor . Although a network meta‐analysis suggested efficacy of pentoxifylline, steroids, and combination therapy of steroids with either NAC or pentoxifylline in comparison with placebo in a group of patients with SAH, there was significant heterogeneity .…”
Section: Accurately Categorizing Aldmentioning
confidence: 99%
“…(3) The guidelines recognize that therapies with potential efficacy for AH may include N -acetyl cysteine (NAC) and granulocyte colony-stimulating factor. (17,18) Although a network meta-analysis suggested efficacy of pentoxifylline, steroids, and combination therapy of steroids with either NAC or pentoxifylline in comparison with placebo in a group of patients with SAH, there was significant heterogeneity. (19) The heterogeneity suggests that fundamentally different studies are being combined, which appears largely accounted for by variability in the individual studies' inclusion criteria.…”
Section: Accurately Categorizing Aldmentioning
confidence: 99%
“…There was only a marginal effect of NAC in a French multicenter trial in patients with SAH treated with corticosteroids (not all had ACLF) [9]. In one of the two Indian RCTs (see above), survival was lower among patients receiving G-CSF plus NAC than among those who received G-CSF alone [8]. …”
Section: Question 6: Do You Apply Any Experimental Drugs Such As N-acmentioning
confidence: 99%
“…G-CSF has been evaluated in the context of SAH in two RCTs performed in India [7,8]. There were limitations: open label, corticosteroids were not used, the presence of ACLF was not assessed, and the RCTs have been performed in a single center (Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh), raising the question of generalizability.…”
Section: Question 6: Do You Apply Any Experimental Drugs Such As N-acmentioning
confidence: 99%