title: Pentoxifylline in severe alcoholic hepatitis: a prospective, randomised trial.
abstract: BACKGROUND
  Role of corticosteroids in treatment of severe alcoholic hepatitis (SAH) is controversial. Pentoxifylline (PTX), an inhibitor of TNF, has also been shown to decrease short term mortality in SAH. Aim of this study was to evaluate the effect of PTX on short term mortality, renal and hepatic functions in patients with SAH.
  
  
  METHODS
  Fifty patients with SAH {Maddrey's Discriminant Function (DF) > or = 32} were prospectively enrolled. Twenty five patients received PTX (400 mg orally, three times a day), and 25 received placebo for 4 weeks. Serum tumor necrosis factor (TNF) was measured in both groups.
  
  
  RESULTS
  Baseline characteristics of the two groups were similar. At 4 weeks, mortality in PTX group was lower than that in controls {20% (5/25) versus 40% (10/25) respectively; p = 0.216; RR 0.5; 95% CI 0.19-1.25}. Renal failure was the cause of mortality in 20% (1/5) patients in PTX group, and 70% (7/10) in controls (p = 0.11). Significant reduction in urea, creatinine, DF and TNF was noted in PTX group. Reduction in TNF did not correlate with reduction in creatinine or DF.
  
  
  CONCLUSIONS
  In patients with SAH, PTX leads to a significant improvement in renal and hepatic functions, and a trend towards decreased short term mortality.
authors.affiliation: Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab.
authors.forename: Sandeep Singh
authors.initials: SS
authors.lastname: Sidhu
authors.forename: Omesh
authors.initials: O
authors.lastname: Goyal
authors.forename: Monika
authors.initials: M
authors.lastname: Singla
authors.forename: K L
authors.initials: KL
authors.lastname: Bhatia
authors.forename: Rajoo Singh
authors.initials: RS
authors.lastname: Chhina
authors.forename: Ajit
authors.initials: A
authors.lastname: Sood
mesh_terms: D000328:Adult; D000368:Aged; D006519:Hepatitis, Alcoholic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008099:Liver / Q000503:physiopathology; D008875:Middle Aged; D010431:Pentoxifylline / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D010726:Phosphodiesterase Inhibitors; D014409:Tumor Necrosis Factor-alpha; D010431:Pentoxifylline