title: Metadoxine improves the three- and six-month survival rates in patients with severe alcoholic hepatitis.
abstract: OBJECTIVE
  To evaluate the impact of metadoxine (MTD) on the 3- and 6-mo survival of patients with severe alcoholic hepatitis (AH).
  
  
  METHODS
  This study was an open-label clinical trial, performed at the "Hospital General de México, Dr. Eduardo Liceaga". We randomized 135 patients who met the criteria for severe AH into the following groups: 35 patients received prednisone (PDN) 40 mg/d, 35 patients received PDN+MTD 500 mg three times daily, 33 patients received pentoxifylline (PTX) 400 mg three times daily, and 32 patients received PTX+MTD 500 mg three times daily. The duration of the treatment for all of the groups was 30 d.
  
  
  RESULTS
  In the groups treated with the MTD, the survival rate was higher at 3 mo (PTX+MTD 59.4% vs PTX 33.3%, P = 0.04; PDN+MTD 68.6% vs PDN 20%, P = 0.0001) and at 6 mo (PTX+MTD 50% vs PTX 18.2%, P = 0.01; PDN+MTD 48.6% vs PDN 20%, P = 0.003) than in the groups not treated with MTD. A relapse in alcohol intake was the primary independent factor predicting mortality at 6 mo. The patients receiving MTD maintained greater abstinence than those who did not receive it (74.5% vs 59.4%, P = 0.02).
  
  
  CONCLUSIONS
  MTD improves the 3- and 6-mo survival rates in patients with severe AH. Alcohol abstinence is a key factor for survival in these patients. The patients who received the combination therapy with MTD were more likely to maintain abstinence than those who received monotherapy with either PDN or PTX.
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: Fátima
authors.initials: F
authors.lastname: Higuera-de la Tijera
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: Alfredo I
authors.initials: AI
authors.lastname: Servín-Caamaño
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: Aurora E
authors.initials: AE
authors.lastname: Serralde-Zúñiga
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: Javier
authors.initials: J
authors.lastname: Cruz-Herrera
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Pérez-Torres
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Abdo-Francis
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: Francisco
authors.initials: F
authors.lastname: Salas-Gordillo
authors.affiliation: Fátima Higuera-de la Tijera, Eduardo Pérez-Torres, Juan M Abdo-Francis, Francisco Salas-Gordillo, José L Pérez-Hernández, Liver Clinic, Gastroenterology Department, Hospital General de México, Dr. Eduardo Liceaga, Mexico City 06720, Mexico.
authors.forename: José L
authors.initials: JL
authors.lastname: Pérez-Hernández
mesh_terms: D000328:Adult; D064829:Alcohol Abstinence; D000427:Alcohol Deterrents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006519:Hepatitis, Alcoholic / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010431:Pentoxifylline / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D016016:Proportional Hazards Models; D011736:Pyridoxine / Q000008:administration & dosage* / Q000009:adverse effects; D011761:Pyrrolidonecarboxylic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000427:Alcohol Deterrents; D004338:Drug Combinations; D005938:Glucocorticoids; C037845:metadoxine; D011736:Pyridoxine; D010431:Pentoxifylline; D011761:Pyrrolidonecarboxylic Acid; D011241:Prednisone
keywords: Alcohol abstinence; Alcoholic hepatitis; Metadoxine; Survival