Lactobacillus therapy reduces heavy drinking in patients with alcohol associated hepatitis

A 6-month Lactobacillus rhamnosus GG treatment for moderate alcohol-associated hepatitis correlated with a decrease in heavy drinking levels to the social drinking or abstinence levels, according to a presentation.

“Counseling therapy in patients, particularly in the placebo treated patients with alcohol use disorder, seems to provide some benefit in reducing drinking levels,” Vatsalya Vatsalya, MD, PhD, MS, MSc, instructor in medicine at the University of Louisville, Kentucky, said during the presentation at The Liver Meeting Digital Experience. “[Lactobacillus rhamnosus GG (LGG)] treatment showed a significant reduction of some biomarkers of liver injury progression and severity.”

Vatsalya and colleagues identified 39 patients with an alcohol use disorder and moderate alcohol-associated hepatitis. Patients were aged 21 to 67 years. Twenty-one patients received LGG and 17 received placebo. Standard medical management for liver disease was used in all patients as well as counseling for alcohol use disorder. At baseline, 1 month, 3 months, and 6 months, investigators collected data on demographics, drinking and liver injury to assess for LGG efficacy is decreasing alcohol consumption.

Results showed patients treated with placebo compared with LGG drank more at baseline (44.33 drinks per week vs. 31.39 drinks per week), although this was not statistically significant, according to Vatsalya. At the 6-month assessment, patients treated with LGG compared with placebo demonstrated a reduction in drinking, to the social or abstinence level of less than four drinks per week (P = .032). For the baseline, 1-month and 6-month assessments, the repeated analysis of variance for the average drinking demonstrated an effect of time (P .001) and within-subjects Time by Treatment efficacy of LGG (P = .02).

According to Vatsalya, out of the 21 patients treated with LGG, 16 had a reduction of alcoholic drinks per week to the social drinking criteria compared with four out of 17 patients treated with placebo. By 6 months, nine patients in the placebo group and six in the LGG group did not continue medical management.

“Results warrant a larger well-designed, rigorous treatment-trial clinical study, which we are currently perusing,” Vatsalya concluded.