Meta-analysis of propylthiouracil for alcoholic liver disease - a CochraneHepato-Biliary Group Review

Aims/Background: The aim of this review, was to determine the benefits and adverse effects of propylthiouracil for patients with alcoholic liver disea se. Methods: Systematic Cochrane Review of randomised clinical trials. The Cochrane Hepato-Biliary Controlled Clinical Trials Register, The Cochrane L ibrary, MEDLINE, and full text searches were combined. All analyses were pe rformed according to the intent ion-to-treat method. Only randomised clinic al trials studying patients with alcoholic steatosis. alcoholic fibrosis, a lcoholic hepatitis and/or alcoholic cirrhosis were included. Interventions encompassed propylthiouracil at any dose versus placebo or no intervention. The trials could be double-blind, single-blind or unblinded. Results: Six randomised clinical trials randomising 710 patients demonstrated no signifi cant effects of propylthiouracil versus placebo on mortality (Peto odds rat io (OR) 0.91, 95% confidence interval (CI) 0.59 to 1.40), liver-related mor tality (OR 0.78, CI 0.45 to 1.33), complications to the liver disease (OR 1 .14, CI 0.58 to 2.24), and liver histology. Propylthiouracil was associated with a nonsignificant trend toward an increased risk of nonserious adverse events (OR 1.49, CI 0.74 to 2.99) and with the rare occurrence of serious adverse events (leukopenia). Conclusions: This systematic review could not demonstrate any significant effect of propylthiouracil on any clinically im portant Outcomes (mortality, liver-related mortality, liver complications a nd liver histology) of patients with alcoholic liver disease.