Is pentoxifylline effective in alcoholic hepatitis? –First update

Medwave. 2016 Jun 14:16 Suppl 2:e6469. doi: 10.5867/medwave.2016.6469.
[Article in English, Spanish]

Abstract

About the update: This article updates the June 2014 Living FRISBEE (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos). It incorporates a new systematic review identifying one study not included in previous reviews. The new evidence leads to substantial changes in the existing evidence.

Asbtract: Pentoxifylline is an inhibitor of tumor necrosis factor, and has been proposed as treatment for alcoholic hepatitis. However, it is not clear if it is effective, or if it adds benefit to the treatment with corticosteroids. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including eight randomized controlled trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded pentoxifylline probably leads to little or no difference in mortality in alcoholic hepatitis.

ACERCA DE LA ACTUALIZACIÓN: Este resumen Epistemonikos (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos) es una actualización del resumen publicado en Junio de 2014. Incorpora una nueva revisión sistemática que identificó un estudio no incluido en las revisiones previas. La incorporación de esta nueva evidencia lleva a cambios sustantivos en la evidencia existente.

Resumen: La pentoxifilina, un inhibidor del factor de necrosis tumoral oral, se ha planteado como un posible tratamiento para la hepatitis alcohólica. Sin embargo, no está claro si es efectiva o si su adición al tratamiento con corticoides agrega beneficios. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen ocho estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la pentoxifilina probablemente no disminuye la mortalidad en pacientes con hepatitis alcohólica.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Hepatitis, Alcoholic / drug therapy*
  • Hepatitis, Alcoholic / mortality
  • Hepatitis, Alcoholic / physiopathology
  • Humans
  • Pentoxifylline / administration & dosage
  • Pentoxifylline / therapeutic use*
  • Phosphodiesterase Inhibitors / administration & dosage
  • Phosphodiesterase Inhibitors / therapeutic use
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Adrenal Cortex Hormones
  • Phosphodiesterase Inhibitors
  • Tumor Necrosis Factor-alpha
  • Pentoxifylline