P- 40 PENTOXIFYLLINE USE IN PATIENTS WITH ALCOHOL-ASSOCIATED HEPATITIS ADMITTED WITH ACUTE KIDNEY INJURY COULD DECREASE SURVIVAL: A GLOBAL STUDY

Introduction and Objectives

Alcohol-associated hepatitis (AH) is a severe entity with a mortality of up to 30–50% at 1 month. Pentoxifylline combined with steroids has not demonstrated benefits in severe AH. Some studies have suggested that pentoxifylline may be beneficial in the subgroup of patients with acute kidney injury (AKI) and AH. However, there is no solid evidence of its benefit in mortality in this setting. This study aimed to determine the benefit of the use of pentoxifylline in patients with severe AH and AKI.

Materials and Methods

Global retrospective cohort study, including patients with severe AH and AKI at admission (2009–2019). We used competing-risk models with liver transplantation as a competing risk to assess the potential effect of pentoxifylline.

Results

We included 655 patients with severe AH and AKI (30 centers from 10 countries). Median age was 48±11.6 years, 26.2% were females, and 52.5% were Caucasian. Around 68.7% of the patients had a prior history of cirrhosis, and 6.6% underwent liver transplantation. The MELD score on admission was 34 [15–74]. 43.2% of the patients used corticosteroids, while only 6.9% used pentoxifylline during hospitalization. In the univariate analysis, the variables independently associated with mortality were the female sex (sHR 0.740; 95%IC:0.577–0.948; p=0.018), MELD (sHR 1.034; 95%IC: 1.020–1048; p<0.001), MELD 3.0 (sHR 1.034,95%IC:1.018–1.049, p<0.001), Maddrey's discriminant function (sHR 1.005, 95%IC:1.003–1.008, p<0.001), serum albumin at admission (sHR 0.756; 95%IC:0.642–0.890; p=0.001), bilirubin at admission (sHR 1.011; 95%IC:1.003–1.019, p=0.006), serum creatinine (sHR 1.083; 95%IC:1.028–1.140, p=0.002) and pentoxifylline use (sHR 1.531, 95%IC:1.107–2.119; p=0.010)(Table). In the multivariate-adjusted model, the use of pentoxifylline was associated with increased mortality (sHR 1.620, 95%IC:1.190–2.204; p=0.002).

Conclusions

The use of pentoxifylline has no benefit in terms of mortality and could decrease survival in patients with AH and AKI.