A Controlled Trial of 6-Methylprednisolone in Acute Alcoholic Hepatitis.

In a prospective double-blind study, 27 patients with alcoholic hepatitis were randomized for 6-methylprednisolone (12 patients) or placebo treatment (15 patients). The mortality was 50% among steroid treated patients and 47% in the control group (P > .05). The role of liver biopsy feasibility at selection is emphasized since the mortality in this group was 10% as opposed to 71% when the procedure was contraindicated (P < .01). Complications in the steroid-treated subjects were similar quantitatively and qualitatively to those observed in the control series. Examination of published reports of mortality in earlier controlled trials suggests a modest trend in favor of corticosteroid therapy for an encephalopathic subgroup of patients but additional data are required for verification. [ABSTRACT FROM AUTHOR]