Sustained alcohol abstinence benefits even advanced cases of alcohol-related cirrhosis
Click Here to Manage Email Alerts
Abstinence from alcohol was associated with reduced risk for hepatic decompensation and mortality among patients with alcohol-related cirrhosis, regardless of disease stage, according to results in Clinical Gastroenterology and Hepatology.
“Our results clearly show that all patients with alcohol-related liver cirrhosis who maintain sustained abstinence from alcohol not only suffer complications of liver cirrhosis significantly less frequently, but also live considerably longer — even in the case of pronounced portal hypertension," Benedikt Silvester Hofer, MD, of the division of gastroenterology and hepatology at the Medical University of Vienna, said in a related press release.
In an observational, single-center study, Hofer and colleagues investigated the clinical implications of abstinence among 320 patients (median age, 57 years; 75.6% men) with alcohol-related cirrhosis and clinically significant portal hypertension, defined as hepatic venous pressure gradient (HVPG) of at least 10 mm Hg. At enrollment, 87.5% of patients had decompensated cirrhosis and the median HVPG was 20 mm Hg, with 53.8% of patients exceeding 20 mm Hg.
During a median follow-up of 36 months, 75.3% of patients remained abstinent and 24.7% continued drinking alcohol. Researchers reported that abstinence correlated with a “significantly reduced” risk for hepatic decompensation (adjusted HR = 0.391; 95% CI, 0.276-0.555), liver-related mortality (aHR = 0.428; 95% CI, 0.263-0.697) and all-cause mortality (aHR = 0.453; 95% CI, 0.3-0.686).
Further, abstaining from alcohol also reduced the cumulative incidence of hepatic decompensation among those with an HVPG of 10 mmHg to 19 mmHg and an HVPG of 20 mmHg or greater. MELD score (aHR = 1.049; 95% CI, 1.004-1.096) was also a “significant independent predictor” of decompensation.
Researchers estimated a lower probability of 3-year decompensation among those who abstained from alcohol for both HVPG measurement groups (32.4% vs. 60% and 57.5% vs. 82.6%, respectively).
“Our new data provide important evidence for the daily counseling of our patients and
show that it is never too late to strive for complete abstinence from alcohol,” Thomas Reiberger, MD, lead study author and associate professor of hepatology at the Medical University of Vienna, said in the release. “However, the study also showed that even patients with sustained abstinence from alcohol are at risk of developing complications, especially if the extent of portal hypertension remains very pronounced. Therefore, all those affected need regular medical check-ups.”
Reference:
- Alcohol abstinence essential even in advanced liver cirrhosis. https://www.eurekalert.org/news-releases/974279. Published Dec. 13, 2022. Accessed Dec. 14, 2022.
Collapse
Read more about
Click Here to Manage Email Alerts