Citations 2
Moderate alcohol-associated hepatitis: A real-world multicenter study
Idalsoaga, Francisco , Díaz, Luis Antonio , Dunn, Winston , Muñoz, Karen E., Caldentey, Vicente, Arnold, Jorge , Ayares, Gustavo , Mortuza, Rokhsana , Maiwall, Rakhi , Qian, Steve , Elfeki, Mohamed A. , Ramírez, Carolina , Malhi, Gurpreet, Ahmed, Adan, Homsi, Hoomam , Abid, Zinia, Echavarría, Victor, Poca, María , Cuyàs, Berta , Ventura‐Cots, Meritxell , Higuera‐de‐la‐Tijera, Fátima , Ayala-Valverde, María , Pérez, Diego , Gómez, Jaime , Abraldes, Juan, Al‐Karaghouli, Mustafa , Jalal, Prasun K. , Ibrahim, Mohamad Ali , García–Tsao, Guadalupe , Havaj, Daniel Ján , Sulejova, Karolina, Chacko, Kristina R. , Yaquich, Pamela, Toro, Luis, Shah, Vijay H. , Kamath, Patrick S. , Mehta, Heer , Arnold, Jorge , Ayares, Gustavo , Mortuza, Rokhsana , Sarin, Shiv Kumar , Maiwall, Rakhi , Qian, Steve , Simonetto, Douglas A , Singal, Ashwani K , Ramirez-Cadiz, Carolina , Poca, Maria , Soriano, German , Cuyas, Berta , Ventura Cots, Meritxell , Higuera-De La Tijera, Fatima , Ayala-Valverde, María , Jalal, Prasun K , Skladaný, Lubomir , Havaj, Daniel J , Chacko, Kristina R , Restrepo, Juan C , Shah, Vijay, Arrese, Marco , Kamath, Patrick S , Bataller, Ramon A , Díaz, Luis A , Elfeki, Mohamed A , Dunn, Winston , Echavaría, Victor , Muñoz, Karen, Zhang, Wei , Simonetto, Douglas A. , Singal, Ashwani K. , Ahmed, Adan, Abid, Zinia, Cabezas, Joaquín , Abraldeṣ, Juan G. , Goyes, Daniela , Selčanová, Světlana Adamcová , Rincón, Diego , Arrese, Marco , Arab, Juan Pablo
Hepatology Communications | March 28, 2025 | Volume: 9 | Issue: 4 | Pages: No page available
Background: Severe alcohol-associated hepatitis (sAH) is a well-characterized disease with high short-term mortality. However, there is limited research on those with a “less severe condition” (moderate AH). This study aims to characterize in-depth patients with moderate AH (mAH), including the performance of mortality scoring systems, key prognostic factors, and survival over time. Methods: A multicenter retrospective cohort study (2009–2019) included patients with mAH (MELD score ≤20 at admission). Cox regression and receiver operating characteristic curves with AUC were used for analysis. Results: We included 1845 patients with AH (20 centers, 8 countries) between 2009 and 2019. mAH was defined as a MELD score ≤20 at admission. Twenty-four percent met the criteria for an mAH episode. Patients with mAH tend to be older and have a higher proportion of females, with a median MELD of 17 (15–19), Maddrey discriminant function (mDF) of 33 (22–40), the trajectory of serum bilirubin of 0.83 (0.60–1.21), and neutrophil-to-lymphocyte ratio (NLR) of 5 (2.96–8.60). The primary causes of death in mAH included multiple organ failure (34.1%) and infections (16.6%). The cumulative survival rates at 30, 90, and 180 days were 94.3%, 90.4%, and 88.2%, respectively. In multivariable analysis, age was the only significant predictor of 30-day mortality (HR 1.49, 95% CI: 1.27–1.76, p <0.001). Mortality prediction models showed poor performance, with AUC for MELD (0.671), mDF (0.726), trajectory of serum bilirubin (0.733), and NLR (0.697). Conclusions: Patients with moderate AH exhibited a mortality of 11.8% at 6 months, primarily driven by multiple organ failure and infections. These patients also exhibit a different clinical profile compared to those with sAH. Tailored models and therapeutic strategies are needed to improve long-term outcomes in mAH.
Comparison Between Dynamic Models for Predicting Response to Corticosteroids in Alcohol‐Associated Hepatitis: A Global Cohort Study
Idalsoaga, Francisco , Díaz, Luis Antonio , Guizzetti, Leonardo , Dunn, Winston , Arnold, Jorge , Ayares, Gustavo , Mortuza, Rokhsana , Mahli, Gurpreet, Islam, Alvi H. , Maiwall, Rakhi , Qian, Steve , Elfeki, Mohamed A. , Ramírez, Carolina , Higuera‐de‐la‐Tijera, Fátima , Al‐Karaghouli, Mustafa , Jalal, Prasun K. , Ibrahim, Mohamad Ali , García‐Tsao, Guadalupe , Havaj, Daniel Ján , Sulejova, Karolina, Shah, Vijay H. , Kamath, Patrick S. , Mehta, Heer , Arnold, Jorge , Ayares, Gustavo , Mortuza, Rokhsana , Sarin, Shiv Kumar , Maiwall, Rakhi , Qian, Steve , Simonetto, Douglas A , Singal, Ashwani K , Elfeki, Mohamed A , Ramirez-Cadiz, Carolina , Cabezas, Joaquín , Ventura Cots, Meritxell , Higuera-De La Tijera, Fatima , Abraldes, Juan G , Jalal, Prasun K , García-Tsao, Guadalupe , Skladaný, Lubomir , Havaj, Daniel J , Kamath, Patrick S , Arrese, Marco , Bataller, Ramon A , Arab, Juan P , Guizzetti, L , Díaz, Luis A , Dunn, Winston , Echavaría, Victor , Zhang, Wei , Simonetto, Douglas A. , Singal, Ashwani K. , Cabezas, Joaquín , Ventura‐Cots, Meritxell , Abraldeṣ, Juan G. , García–Tsao, Guadalupe , Goyes, Daniela , Selčanová, Světlana Adamcová , Rincón, Diego , Arrese, Marco , Arab, Juan Pablo
Alimentary Pharmacology & Therapeutics | February 19, 2025 | Volume: 61 | Issue: 8 | Pages: 1391-1395
ABSTRACTSeveral dynamic models predict mortality and corticosteroid response in alcohol‐associated hepatitis (AH), yet no consensus exists on the most effective model. This study aimed to assess predictive models for corticosteroid response and short‐term mortality in severe AH within a global cohort. We conducted a multi‐national study of patients with severe AH treated with corticosteroids for at least 7 days, enrolled between 2009 and 2019. Dynamic models—Lille‐4, Lille‐7, trajectory of serum bilirubin (TSB), and neutrophil‐to‐lymphocyte ratio (NLR)—were used to estimate 30‐ and 90‐day mortality. Lille‐7 demonstrated the highest accuracy for both 30‐ and 90‐day mortality.