A Lille model for predicting the response of severe alcoholic hepatitis to corticosteroid treatment in Japanese patients

Yuji Suzuki; Keisuke Kakisaka; Akiko Suzuki; Takeshi Takahara; Tokio Sasaki; Takuro Sato; Takehiro Yonezawa; Hiroyuki Nitta; Yasuhiro Takikawa

doi:10.1111/hepr.13334

A Lille model for predicting the response of severe alcoholic hepatitis to corticosteroid treatment in Japanese patients

Hepatol Res. 2019 Jul;49(7):758-764. doi: 10.1111/hepr.13334. Epub 2019 Apr 29.

Authors

Yuji Suzuki¹, Keisuke Kakisaka¹, Akiko Suzuki¹, Takeshi Takahara², Tokio Sasaki¹, Takuro Sato¹, Takehiro Yonezawa¹, Hiroyuki Nitta², Yasuhiro Takikawa¹

Affiliations

¹ Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan.
² Department of Surgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.

PMID: 30901152
DOI: 10.1111/hepr.13334

Abstract

Aim: Corticosteroids are the most widely used agents for the treatment of severe alcoholic hepatitis (SAH). The therapeutic effectiveness of corticosteroids is assessed by the Lille model, which has been validated well in patient cohorts in North America and Europe; however, its usefulness has not yet been confirmed independently in Japanese patients. The present study aimed to determine whether the Lille model could predict the prognosis of SAH in Japanese patients.

Methods: This was a retrospective cohort study including 32 SAH patients who were admitted to our institute from April 2011 to February 2018. According to the previously validated Lille model cut-off value, patients who received corticosteroids were classified as corticosteroid responders or non-responders (with responders obtaining a Lille score ≥ 0.45), followed by assessment for the 6-month prognosis.

Results: Out of 32 patients, 26 were treated with corticosteroids. The 28-day and 6-month mortality rates in the corticosteroid-treated group were 23.1% and 46.2%, respectively. The median Lille score was significantly higher in patients who died or underwent liver transplantation (0.647) than in those who survived without undergoing transplantation (0.226; P < 0.0182). The 6-month transplant-free survival rate of non-responders (Lille score ≥ 0.45) was significantly lower (27.3%; 95% confidence interval, 9.0-58.6%) than that of responders (Lille score < 0.45, 73.3%; 95% confidence interval, 46.7-90.0%; P = 0.0149, log-rank test).

Conclusions: The Lille score could be useful for predicting the 6-month prognosis of Japanese SAH patients after corticosteroid therapy.

Keywords: Lille model; prognosis; severe alcoholic hepatitis.