Comparison Between Dynamic Models for Predicting Response to Corticosteroids in Alcohol-Associated Hepatitis: A Global Cohort Study

Aliment Pharmacol Ther. 2025 Apr;61(8):1391-1395. doi: 10.1111/apt.70024. Epub 2025 Feb 18.

Abstract

Several dynamic models predict mortality and corticosteroid response in alcohol-associated hepatitis (AH), yet no consensus exists on the most effective model. This study aimed to assess predictive models for corticosteroid response and short-term mortality in severe AH within a global cohort. We conducted a multi-national study of patients with severe AH treated with corticosteroids for at least 7 days, enrolled between 2009 and 2019. Dynamic models-Lille-4, Lille-7, trajectory of serum bilirubin (TSB), and neutrophil-to-lymphocyte ratio (NLR)-were used to estimate 30- and 90-day mortality. Lille-7 demonstrated the highest accuracy for both 30- and 90-day mortality.

Keywords: alcohol; alcoholic cirrhosis; alcohol‐associated liver disease; alcohol‐related hepatitis; cirrhosis; end‐stage liver disease; outcome prediction.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adrenal Cortex Hormones* / therapeutic use
  • Adult
  • Aged
  • Bilirubin / blood
  • Cohort Studies
  • Female
  • Hepatitis, Alcoholic* / drug therapy
  • Hepatitis, Alcoholic* / mortality
  • Humans
  • Male
  • Middle Aged
  • Neutrophils
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Bilirubin