Alcoholic liver disease: Treatment

Table 1 Treatment for alcoholic hepatitis

	Target	Method	Characteristic
Abstinence	Stop drinking	Baclofen, acamprosate, naltrexone, and psychotherapy	The role of pharmacologic agents in maintaining abstinence is unclear.
Nutritional support	Correct malnutrition	1.2-1.5 g/kg per day of protein and 35-40 kcal/kg per day	Vitamin A, thiamine, vitamin B12, folic acid, pyridoxine, vitamin D, magnesium, selenium, and zinc may be administered.
Corticosteroid	Decrease inflammation	Prednisolone 40 mg/d for 28 d followed by tapering over 2-4 wk	Increase in the serum bilirubin and Lille score > 0.45 after 1 wk of therapy are associated with worse outcome
Pentoxifylline	Ablate cytokines	400 mg 3 times/d for 28 d	Protective effect against hepatorenal syndrome
Infliximab	Ablate TNF-α	Not confirmed	Further studies are needed
Etanercept	Ablate TNF-α
N-acetylcysteine	Anti-oxidant
Metadoxine	Anti-oxidant
Propylthiouracil	Reduce ischemic damage
Colchicine	Anti-fibrosis
PL	Anti-fibrosis
AIIR blocker	Anti-fibrosis
Silymarin	Anti-oxidant and anti-fibrosis

PL: Polyunsaturated lecithin; AIIR: Angiotensin II receptor; TNF: Tumor necrosis factor.