Low alcohol consumption influences outcomes in individuals with alcohol-related compensated cirrhosis in a French multicenter cohort.
alcohol-related liver disease
cirrhosis
liver decompensation
recurrence
Journal
Journal of hepatology
ISSN: 1600-0641
Titre abrégé: J Hepatol
Pays: Netherlands
ID NLM: 8503886
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
07
04
2022
revised:
24
10
2022
accepted:
04
11
2022
pubmed:
25
11
2022
medline:
3
3
2023
entrez:
24
11
2022
Statut:
ppublish
Résumé
The harmful impact of heavy alcohol consumption and recurrence in patients with alcohol-related cirrhosis is long-established, although this is based on old studies. However, the drivers of long-term outcome still need to be clearly investigated. All patients with biopsy-proven compensated alcohol-related cirrhosis included in the CIRRAL cohort (22 centers) were prospectively studied. Prognostic variables of survival and liver event-free survival were assessed using multivariable Cox models with stepwise selection. The prognostic impact of alcohol recurrence during follow-up (computed in glass-years in the same way as pack-years for tobacco) was assessed using a time-dependent covariable. From 2010 to 2016, 650 patients were included. The median age at baseline was 58.4 years, 67.4% were men and the median BMI was 27.8 kg/m This prospective study in patients with compensated alcohol-related cirrhosis identifies factors predictive of alcohol recurrence during follow-up and shows that moderate alcohol consumption during follow-up negatively impacts outcomes. Patients with alcohol-related cirrhosis should be advised to completely stop drinking alcohol. CIRRAL (NCT01213927) cohort was registered at ClinicalTrials.gov and the full protocol is available at the following link: https://clinicaltrials.gov/ct2/show/NCT01213927. In patients with alcohol-related cirrhosis, data are lacking about the impact of the amount of alcohol consumed on both survival and liver-related events. The present study based on the CIRRAL cohort demonstrates that alcohol recurrence occurs in more than 30% of patients with compensated cirrhosis and that even a moderate recurrence strongly influences outcomes. Patients with compensated alcohol-related cirrhosis should be advised to completely discontinue alcohol consumption, even in small amounts, as the present study shows that no alcohol consumption can be regarded as safe when cirrhosis has developed.
Sections du résumé
BACKGROUND & AIMS
The harmful impact of heavy alcohol consumption and recurrence in patients with alcohol-related cirrhosis is long-established, although this is based on old studies. However, the drivers of long-term outcome still need to be clearly investigated.
METHOD
All patients with biopsy-proven compensated alcohol-related cirrhosis included in the CIRRAL cohort (22 centers) were prospectively studied. Prognostic variables of survival and liver event-free survival were assessed using multivariable Cox models with stepwise selection. The prognostic impact of alcohol recurrence during follow-up (computed in glass-years in the same way as pack-years for tobacco) was assessed using a time-dependent covariable.
RESULTS
From 2010 to 2016, 650 patients were included. The median age at baseline was 58.4 years, 67.4% were men and the median BMI was 27.8 kg/m
CONCLUSION
This prospective study in patients with compensated alcohol-related cirrhosis identifies factors predictive of alcohol recurrence during follow-up and shows that moderate alcohol consumption during follow-up negatively impacts outcomes. Patients with alcohol-related cirrhosis should be advised to completely stop drinking alcohol.
REGISTRATION
CIRRAL (NCT01213927) cohort was registered at ClinicalTrials.gov and the full protocol is available at the following link: https://clinicaltrials.gov/ct2/show/NCT01213927.
IMPACT AND IMPLICATIONS
In patients with alcohol-related cirrhosis, data are lacking about the impact of the amount of alcohol consumed on both survival and liver-related events. The present study based on the CIRRAL cohort demonstrates that alcohol recurrence occurs in more than 30% of patients with compensated cirrhosis and that even a moderate recurrence strongly influences outcomes. Patients with compensated alcohol-related cirrhosis should be advised to completely discontinue alcohol consumption, even in small amounts, as the present study shows that no alcohol consumption can be regarded as safe when cirrhosis has developed.
Identifiants
pubmed: 36423805
pii: S0168-8278(22)03304-9
doi: 10.1016/j.jhep.2022.11.013
pii:
doi:
Substances chimiques
Ethanol
3K9958V90M
Banques de données
ClinicalTrials.gov
['NCT01213927']
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
501-512Investigateurs
Nathalie Ganne-Carrié
(N)
Valérie Bourcier
(V)
Cendrine Chaffaut
(C)
Sylvie Chevret
(S)
Isabelle Archambeaud
(I)
Jérôme Gournay
(J)
None Louis d'Alteroche
Laure Elkrief
(L)
Frédéric Oberti
(F)
Isabelle Fouchard-Hubert
(I)
Dominique Roulot
(D)
Christophe Moreno
(C)
Alexandre Louvet
(A)
Thông Dao
(T)
Romain Moirand
(R)
Jean-Charles Duclos-Vallée
(JC)
Odile Goria
(O)
Eric Nguyen-Khac
(E)
Stanislas Pol
(S)
Nicolas Carbonell
(N)
Jean-Marie Péron
(JM)
Victor de Lédinghen
(V)
Violaine Ozenne
(V)
Jean Henrion
(J)
Albert Tran
(A)
Gabriel Perlemuter
(G)
Xavier Amiot
(X)
Jean-Pierre Zarski
(JP)
Informations de copyright
Copyright © 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.