Meta-analysis of propylthiouracil for alcoholic liver disease--a Cochrane Hepato-Biliary Group Review.
OBJECTIVE
The aim of this review was to determine the benefits and adverse effects of propylthiouracil for patients with alcoholic liver disease.


METHODS
Systematic Cochrane Review of randomised clinical trials. The Cochrane Hepato-Biliary Controlled Clinical Trials Register, The Cochrane Library, MEDLINE, and full text searches were combined. All analyses were performed according to the intention-to-treat method. Only randomised clinical trials studying patients with alcoholic steatosis, alcoholic fibrosis, alcoholic hepatitis and/or alcoholic cirrhosis were included. Interventions encompassed propylthiouracil at any dose versus placebo or no intervention. The trials could be double-blind, single-blind or unblinded.


RESULTS
Six randomised clinical trials randomising 710 patients demonstrated no significant effects of propylthiouracil versus placebo on mortality (Peto odds ratio (OR) 0.91, 95% confidence interval (CI) 0.59 to 1.40), liver-related mortality (OR 0.78, CI 0.45 to 1.33), complications to the liver disease (OR 1.14, CI 0.58 to 2.24), and liver histology. Propylthiouracil was associated with a nonsignificant trend toward an increased risk of nonserious adverse events (OR 1.49, CI 0.74 to 2.99) and with the rare occurrence of serious adverse events (leukopenia).


CONCLUSIONS
This systematic review could not demonstrate any significant effect of propylthiouracil on any clinically important outcomes (mortality, liver-related mortality, liver complications and liver histology) of patients with alcoholic liver disease.
Rambaldi
A
A
Cochrane Hepato-Biliary Group, The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, H:S Rigshopitalet, Copenhagen, Denmark.
Gluud
C
C
D013956:Antithyroid Agents / Q000627:therapeutic use*; D006501:Hepatic Encephalopathy / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011441:Propylthiouracil / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome
D013956:Antithyroid Agents; D011441:Propylthiouracil