title: Pentoxifylline Plus Prednisolone versus Pentoxifylline Only for Severe Alcoholic Hepatitis: A Randomized Controlled Clinical Trial.
abstract: BACKGROUND
  Prednisolone and pentoxifylline (PTX) have been shown to be individually useful in severe alcoholic hepatitis with Maddrey discriminant function (MDF) score ≥32. Previous report suggests that PTX is probably superior to prednisolone alone. However the efficacy of PTX and prednisolone combination over PTX alone in the management of acute alcoholic hepatitis (MDF score ≥32) is yet unrevealed.
  
  
  OBJECTIVE
  The present study was initiated to find out the efficacy of combined pentoxifylline and prednisolone versus PTX alone in acute alcoholic hepatitis in respect of short and intermediate term outcomes.
  
  
  METHODS
  A total of 124 patients with severe alcoholic hepatitis (MDF score ≥ 32) initially were evaluated. 62 patients who fulfilled the inclusion and exclusion criteria were randomized and divided into 2 groups. Group 1 received PTX only, whereas Group 2 received PTX plus Prednisolone. The total duration of follow-up was 12 months. Student's t-test, Chi-square test, the Kaplan-Meier methods were used for statistical analysis.
  
  
  RESULTS
  A total of 60 patients, 30 in each group were available for final analysis. In Group-1, 6 patients expired at the end of 1 year (5 within 3 months and another after 3 months). In Group 2, 10 patients expired at the end of 1 year (9 within 3 months and another after 3 months). Though survival probability is higher among Group 1 patients but the difference is not statistically significant.
  
  
  CONCLUSIONS
  The combination of PTX plus Prednisolone yields no additional benefit in terms of mortality and morbidity from that of PTX monotherapy.
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: Bk
authors.initials: B
authors.lastname: De
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: Sk
authors.initials: S
authors.lastname: Mandal
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: D
authors.initials: D
authors.lastname: Sau
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: S
authors.initials: S
authors.lastname: Mani
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: S
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: Ss
authors.initials: S
authors.lastname: Mondal
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: K
authors.initials: K
authors.lastname: Bhattacharya
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: K
authors.initials: K
authors.lastname: Sil
authors.affiliation: Department of Medicine, Medical College, Kolkata, West Bengal, India.
authors.forename: R
authors.initials: R
authors.lastname: Bhattacharya
keywords: Alcoholic hepatitis; Maddrey discriminant function score; Pentoxifylline; Prednisolone