Treatment of Severe Alcoholic Hepatitis With Corticoids Plus N Acetyl Cysteine Versus Corticoids Alone
Treatment of Severe Alcoholic Hepatitis With Corticoids Plus N Acetyl Cysteine Versus Corticoids Alone
35% of Acute Alcoholic Hepatitis patients (AAH) do not respond to corticoids and died after 6
 months. Chronic alcohol abuse depletes glutathione in the hepatocytes and makes the latter
 more sensitive to excessive TNFα levels. Re-establishment of a stock of antioxidants by
 administration of a precursor (N-acetyl cysteine, NAC) in combination with corticoids (C)
 could make the hepatocytes more resistant and improve survival. The investigators' study's
 primary endpoint was improvement of survival at 6 months. The secondary endpoints were
 survival at 1 and 3 months, tolerance of NAC and a drop in blood bilirubin levels at D7
AAH patients (Maddrey score > 32 and compatible histological results) should centrally
 randomized into the C-NAC or C groups. Both groups received 4 weeks of prednisolone
 treatment, plus NAC for the combination therapy group (D1: 150, 50 and 100 mg/kg in 250, 500
 and 1000 mL of 5% glucose-saline (G5%) respectively, at t=30 minutes, 4 and 16 hours; D2 to
 D5, 100 mg/kg in 1000 mL of G5%). Group C received 1000 mL of G5%, D1-5
Inclusion Criteria:

 -  Patient consent

 -  Chronic alcohol intake in the last 3 to 6 months

 -  Maddrey score ≥ 32

 -  Liver histology compatible

 Exclusion Criteria:

 -  Hepato renal syndrome

 -  Hepatocarcinoma

 -  Recent variceal haemorrhage

 -  Recent bacterial infections

 -  Other liver diseases associated (HCV, HBV, hemochromatosis, AIH)

 -  Cancers or cardiac and respiratory, HIV infection

 -  NAC Allergy

 -  No patient consent

 -  Acetaminophen intoxication