Management of severe alcoholic hepatitis-steroid or pentoxiphylline?

Alcohol use is common worldwide. Although used as a pleasurable substance, it has been associated with both acute and chronic diseases. Alcoholic hepatitis is a major life-threatening illness caused by chronic alcohol intake. Corticosteroids remain the mainstay of treatment in severe alcoholic hepatitis. Pentoxiphylline is used as an alternative drug where corticosteroids are contraindicated. In this review, we attempted to evaluate the largest multi-centric trial, “STOPAH”, which focused on possible treatment modalities for severe alcoholic hepatitis. This trial used a factorial design to evaluate the efficacy of corticosteroid and pentoxiphylline in alcoholic hepatitis management. In this article, the STOPAH trial is summarised in the first section, followed by comments which enumerates strengths, limitations and utility of trial results.