4.7 Review

Management of alcoholic hepatitis: A clinical perspective

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Long-term Outcomes of Stool Transplant in Alcohol-associated Hepatitis-Analysis of Clinical Outcomes, Relapse, Gut Microbiota and Comparisons with Standard Care

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Review article: current and emerging therapies for acute alcohol-associated hepatitis

Puru Rattan et al.

Summary: Alcohol-associated hepatitis is a serious liver disease with high mortality. Current therapies, including corticosteroids, have limited efficacy. The understanding of the pathophysiology has led to the development of new therapies, and multidisciplinary approaches using digital health technologies are needed to tackle this increasing burden.

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IL-1 receptor antagonist plus pentoxifylline and zinc for severe alcohol-associated hepatitis

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Gyongyi Szabo et al.

Summary: In recent years, there has been significant progress in understanding alcohol-associated hepatitis (AH), accompanied by an increase in clinical trial activity. This review focuses on breakthroughs in AH understanding, which are leading to new paradigms for biomarker discovery, clinical trial activity, and patient care models. It suggests a future where multimodal data can be integrated to generate personalized biomarkers and therapies for patients with AH.

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A phase II, multicenter, open-label, randomized trial of pegfilgrastim for patients with alcohol-associated hepatitis

John A. Tayek et al.

Summary: This trial aimed to evaluate the safety and efficacy of long-acting recombinant GCSF in patients with AH in the United States. The results showed that there was no significant survival benefit at 90 days in patients treated with pegfilgrastim+prednisolone compared to those treated with prednisolone alone. The incidence of complications and adverse events were similar between the two groups.

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Neutrophils interact with cholangiocytes to cause cholestatic changes in alcoholic hepatitis

Masahiro Takeuchi et al.

Summary: In this study, researchers found that neutrophils in contact with bile ducts contribute to cholestasis in alcoholic hepatitis by binding to ITGB1 on cholangiocytes. The loss of ITPR3 in cholangiocytes co-cultured with neutrophils was observed, and AH neutrophils were found to be more potent than control neutrophils. This new understanding of the role of cholangiocytes in the pathogenesis of AH could lead to the identification of new therapeutic targets.
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Alcohol and other substance use during the COVID-19 pandemic: A systematic review

Amanda Roberts et al.

Summary: The systematic review found that alcohol and other substance use showed different trends during the Covid-19 pandemic. While there was an overall increase in alcohol consumption, the use of other substances also significantly increased. Mental health factors played a key role in the increased use of both alcohol and other substances.

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Development and prognostic relevance of a histologic grading and staging system for alcohol-related liver disease

Carolin Lackner et al.

Summary: The SALVE Histopathology Group developed and validated a grading and staging system for alcohol-related liver disease (ALD) and evaluated its prognostic utility in a multinational cohort of 445 patients. The system showed significant associations with disease activity and fibrosis stage, impacting both long-term and short-term outcomes in ALD patients.

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IL-1 Signal Inhibition In Alcoholic Hepatitis (ISAIAH): a study protocol for a multicentre, randomised, placebo-controlled trial to explore the potential benefits of canakinumab in the treatment of alcoholic hepatitis

N. Vergis et al.

Summary: This study aims to explore the potential benefits of the IL-1 beta antibody, canakinumab, in treating alcoholic hepatitis (AH) by conducting a randomized trial with 58 participants to compare histological appearances and mortality rates before and after treatment.

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No Effect in Alcoholic Hepatitis of Gut-Selective, Broad-Spectrum Antibiotics on Bacterial Translocation or Hepatic and Systemic Inflammation

Sidsel Stoy et al.

Summary: In patients with alcoholic hepatitis, gut-targeted antibiotic treatment did not change markers of bacterial translocation and liver and systemic inflammation. The study suggests that bacterial translocation may be less important once the inflammatory process is established, or that reducing the gut bacteriome may be less important than altering its composition.

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PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis

Jonel Trebicka et al.

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Identification of optimal therapeutic window for steroid use in severe alcohol-associated hepatitis: A worldwide study

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Mengfei Liu et al.

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