Methylprednisolone improves survival in liver failure due to hepatitis B: Study

China: The use of methylprednisolone (MP) is a safe and effective treatment for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) increasing the survival rate of 6 months, reveals a recent study in the journal BMC Medicine.

In Asia, HBV-ACLF accounts for about 70% of all ACLF cases, which is identified with severe acute exacerbation (AE) of liver function to liver failure in chronic hepatitis B (CHB) patients with high mortality. Only curative treatment for ACLF is liver transplantation with limited application. Up til now no effective treatment has been developed for HBV-ACLF patients. The use of MP in HBV-ACLF is still controversial.

Qing-Hua Meng, Capital Medical University, Beijing, China, and colleagues aimed to evaluate the efficacy and safety of MP in HBV-ACLF.

It included a total of 171 HBV-ACLF patients from three medical centers. They were randomly allocated into two groups. MP group consisted of 2 patients treated with intravenously guttae for 7 days plus standard treatment: 1.5 mg/kg/day [day 1–3], 1 mg/kg/day [day 4–5], and 0.5 mg/kg/day [day 6–7]. Control group consisted of 88 patients treated with standard treatment.  

The primary endpoints were 6-month mortality and prognostic factors for 6-month survival. The survival time, cause of death, adverse events, liver function, and HBV DNA replication were analyzed.  

"Our findings demonstrate that MP therapy is an effective and safe clinical strategy in HBV-ACLF, increasing the 6-month survival rate," concluded the authors. 

"The efficacy and safety of methylprednisolone in hepatitis B virus-related acute-on-chronic liver failure: a prospective multi-center clinical trial," is published in the journal BMC Medicine.

DOI: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01814-4