2026-04-17T02:50:35Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/132142025-10-24T10:28:27Zcom_2072_378070com_2072_378040col_2072_378092

Pentoxifylline use in alcohol-associated hepatitis with acute kidney injury does not improve survival: a global study Idalsoaga, Francisco Caldentey, Vicente Díaz, Luis Antonio Dunn, Winston Mehta, Heer Arnold, Jorge Ventura-Cots, Meritxell Hepatitis - Tractament Hepatitis - Mortalitat Alcoholisme Fosfodiesterases - Inhibidors - Ús terapèutic - Efectes secundaris Insuficiència renal aguda - Tractament Avaluació de resultats (Assistència sanitària) DISEASES::Digestive System Diseases::Liver Diseases::Hepatitis::Hepatitis, Alcoholic Other subheadings::Other subheadings::Other subheadings::/drug therapy CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Enzyme Inhibitors::Phosphodiesterase Inhibitors Other subheadings::Other subheadings::Other subheadings::/adverse effects DISEASES::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Acute Kidney Injury ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome::Treatment Failure ENFERMEDADES::enfermedades del sistema digestivo::enfermedades hepáticas::hepatitis::hepatitis alcohólica Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::inhibidores enzimáticos::inhibidores de fosfodiesterasas Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos ENFERMEDADES::enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales::insuficiencia renal::lesión renal aguda TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento::fracaso del tratamiento Acute kidney injury; Liver diseases, alcoholic; Pentoxifylline Lesión renal aguda; Enfermedades hepáticas alcohólicas; Pentoxifilina Lesió renal aguda; Malalties hepàtiques alcohòliques; Pentoxifil·lina Background Severe alcohol-associated hepatitis (sAH) is a life-threatening condition with high mortality, where corticosteroid use is the only treatment that has shown short-term benefits. Pentoxifylline, an anti-tumour necrosis factor-alpha agent, has been proposed for its potential to improve outcomes, especially in patients with acute kidney injury (AKI). We aimed to evaluate the impact of pentoxifylline on mortality in patients with sAH and AKI in a well-characterised global cohort. Methods We conducted a retrospective, registry-based study including patients meeting the National Institute on Alcohol Abuse and Alcoholism clinical criteria for sAH and AKI. Mortality was the primary endpoint, with liver transplantation as a competing risk. Statistical analysis included Cox regression and Kaplan-Meier survival estimates. Results We included 525 patients from 20 centres across eight countries. The median age was 48 years, with 26.1% females, and 76.9% had a history of cirrhosis. Multivariable Cox regression models showed that pentoxifylline use was not associated with survival (HR 1.20, 95% CI 0.85 to 1.69, p=0.291). Factors associated with mortality included age (HR 1.23, 95% CI 1.10 to 1.36, p<0.001), Model for End-Stage Liver Disease score at admission (HR 1.06, 95% CI 1.04 to 1.08, p<0.001) and renal replacement therapy use (HR 1.39, 95% CI 1.05 to 1.84, p=0.019). The main causes of death were multiple organ failure (42%), infections (10%), oesophageal varices bleeding (7%) and renal failure (6%). Conclusion Pentoxifylline showed no significant benefit on mortality in patients with sAH and AKI. Further studies are needed to refine treatment strategies for this high-risk group. MA receives support from the Chilean government through the Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT 1241450). 2025-10-24T10:28:27Z 2025-10-24T10:28:27Z 2025-10-24T10:28:27Z 2025-06-05T10:00:40Z 2025-06-05T10:00:40Z 2025-04 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/13214 eGastroenterology;3(2) https://doi.org/10.1136/egastro-2024-100179 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess BMJ Scientia