Current therapy of chronic liver disease

Michael W. Stavinoha, Roger D. Soloway

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The study of chronic liver disease has been hampered by insufficient information relative to the pathogenesis of the many forms of hepatitis. Consequently, well-designed treatment strategies are frequently lacking. Wilson's disease is characterised by excessive copper accumulation in the liver and other organs. While d-penicillamine is clearly effective, many patients may not tolerate its many adverse effects. Trientine, oral zinc and unithiol have all shown promise as therapeutic alternatives. Autoimmune chronic active hepatitis responds well to prednisone and azathioprine. Cyclosporin has also produced clinical improvement in several case reports but no comparison has yet been made with the current standard therapy. Recombinant interferonα (IFNα) has demonstrated the ability to inhibit hepatitis B viral replication, and the combination of oral corticosteroids followed by IFNα is more effective than either agent alone in eliminating viral replication in patients with chronic active hepatitis B. Currently, primary sclerosing cholangitis (PSC) has no standard medical management, but corticosteroids and methotrexate may each have a future role in its treatment. Drug treatment for primary biliary cirrhosis (PBC) has been disappointing, and early reports of success with d-penicillamine were not confirmed in large well-controlled trials. While some reports of improvement with several agents have been described, larger studies are still needed. Alcoholic liver disease continues to be associated with significant morbidity and mortality and numerous investigators have researched several different medical avenues of treatment. Success reported with androgens and the antithyroid agent propylthiouracil in alcoholic liver disease will need confirmation by other research before these agents can be recommended for routine use. Finally, colchicine may prove to be effective in slowing the rate of fibrosis in cirrhosis, but this has yet to be conclusively proven.

Original languageEnglish (US)
Pages (from-to)814-840
Number of pages27
JournalDrugs
Volume39
Issue number6
StatePublished - Jun 1990

Fingerprint

Liver
Liver Diseases
Chronic Disease
Penicillamine
Interferons
Alcoholic Liver Diseases
Adrenal Cortex Hormones
Unithiol
Chronic Hepatitis
Trientine
Drug therapy
Antithyroid Agents
Propylthiouracil
Azathioprine
Colchicine
Fibrosis
Therapeutics
Prednisone
Methotrexate
Cyclosporine

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

Stavinoha, M. W., & Soloway, R. D. (1990). Current therapy of chronic liver disease. Drugs, 39(6), 814-840.

Current therapy of chronic liver disease. / Stavinoha, Michael W.; Soloway, Roger D.

In: Drugs, Vol. 39, No. 6, 06.1990, p. 814-840.

Research output: Contribution to journalArticle

Stavinoha, MW & Soloway, RD 1990, 'Current therapy of chronic liver disease', Drugs, vol. 39, no. 6, pp. 814-840.
Stavinoha MW, Soloway RD. Current therapy of chronic liver disease. Drugs. 1990 Jun;39(6):814-840.
Stavinoha, Michael W. ; Soloway, Roger D. / Current therapy of chronic liver disease. In: Drugs. 1990 ; Vol. 39, No. 6. pp. 814-840.
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