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001-es BibID:	BIBFORM101156
035-os BibID:	(Scopus)85128889535 (WOS)000804710000001
Első szerző:	Szabó Gyöngyi
Cím:	IL-1 receptor antagonist plus pentoxifylline and zinc for severe alcohol-associated hepatitis / Gyöngyi Szabó, Mack Mitchell, Craig J. McClain, Srinivasan Dasarathy, Bruce Barton, Arthur McCullough, Laura E. Nagy, Aimee Kroll-Desrosiers, David Tornai, Hyesung Alice Min, Svetlana Radaeva, M. E. Blair Holbein, Lisa Casey, Jennifer Cuthbert
Dátum:	2022
ISSN:	0270-9139
Megjegyzések:	Background & aims: Patients with severe alcohol-associated hepatitis (AH) have high mortality. Corticosteroids improve survival only for 30 days. We targeted inflammation, cellular injury and gut leakiness in a randomized clinical trial comparing combination therapy to corticosteroids on 180-day survival. Approach & results: Subjects with a clinical diagnosis of severe AH (MELD>20, MDF>32) were randomized to receive methylprednisolone (28 days) (PRED) or a combination of anakinra (14 days) plus pentoxifylline (28 days) plus zinc (180 days) (COMB). The primary endpoint was survival at 180 days. The study was designed in 2013, initiated in October 2014 and completed in March 2018. Five hundred (500) patients were screened to randomize 104 subjects with a clinical diagnosis of AH with a Model for End Stage Liver Disease (MELD) score > 20. Fifty-three (53) patients were randomized into the COMB and fifty (50) to the PRED treatment; one dropped out of the study before randomization. The mean age was 45.3?10.4 years. 60.6% were males, 92.3% white, mean MELD 25.7?3.9. Kaplan-Meier survival estimate at 180-day was 67.9% in COMB and 56% in PRED (HR=0.69; p=0.3001). Survival curves separated by 90 days (COMB: 69.8%; PRED: 58.0%; HR=0.69, p=0.28). Survival at 28 days was similar between the COMB (83.4%) and PRED groups (81.2%) (HR=0.91, p=0.85). There were no unexpected serious adverse events and the incidence of infection was comparable between groups. MELD 20-25 and MELD >26 strata showed non-significant treatment effects in favor of COMB. Conclusions: A combination of anakinra, pentoxifylline plus zinc provides similar survival benefits compared to corticosteroid therapy in severe AH.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Interleukin-1 antagonist MELD inflammation interleukin-1 liver failure
Megjelenés:	Hepatology. - 76 : 4 (2022), p. 1058-1068. -
További szerzők:	Mitchell, Mack McClain, Craig Dasarathy, Srinivasan Barton, Bruce McCullough, Arthur Nagy Laura E. Kroll-Desrosiers, Aimee Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Min, Hyesung Alice Radaeva, Svetlana Holbein, M. E. Blair Casey, Lisa Cuthbert, Jennifer
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