Hey, Myron, good to hear from you. Here's something hot off the presses......
J Hepatol 1999 Jun;30(6):1081-9
S-adenosylmethionine in alcoholic liver cirrhosis: a randomized,
placebo-controlled, double-blind, multicenter clinical trial.
Mato JM, Camara J, Fernandez de Paz J, Caballeria L, Coll S, Caballero A, Garcia-Buey L, Beltran J, Benita V,
Caballeria J, Sola R, Moreno-Otero R, Barrao F, Martin-Duce A, Correa JA, Pares A, Barrao E, Garcia-Magaz I,
Puerta JL, Moreno J, Boissard G, Ortiz P, Rodes J
Department of Medicine, University of Navarra, Pamplona, Spain. jmmato@unav.es
[Medline record in process]
BACKGROUND/AIM: The efficacy of S-adenosylmethionine (AdoMet) in the treatment of liver cell injury has been
demonstrated in several experimental models. The aim of this study was to investigate the effects of AdoMet treatment in
human alcoholic liver cirrhosis. METHODS: A randomized, double-blind trial was performed in 123 patients treated with
AdoMet (1200 mg/day, orally) or placebo for 2 years. All patients had alcoholic cirrhosis, and histologic confirmation of the
diagnosis was available in 84% of the cases. Seventy-five patients were in Child class A, 40 in class B, and 8 in class C.
Sixty-two patients received AdoMet and 61 received placebo. RESULTS: At inclusion into the trial no significant differences
were observed between the two groups with respect to sex, age, previous episodes of major complications of cirrhosis, Child
classification and liver function tests. The overall mortality/liver transplantation at the end of the trial decreased from 30% in the
placebo group to 16% in the AdoMet group, although the difference was not statistically significant (p = 0.077). When patients
in Child C class were excluded from the analysis, the overall mortality/liver transplantation was significantly greater in the
placebo group than in the AdoMet group (29% vs. 12%, p = 0.025), and differences between the two groups in the 2-year
survival curves (defined as the time to death or liver transplantation) were also statistically significant (p = 0.046).
CONCLUSIONS: The present results indicate that long-term treatment with AdoMet may improve survival or delay liver
transplantation in patients with alcoholic liver cirrhosis, especially in those with less advanced liver disease. |
