Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis

Lim WH 1 , Tay P 1 , Ng CH 2 , Tan DJH 1 , Ong C 1 , Koh JH 1 Show all authors , Teng M 1 , Chee D 2 , Wong ZY 3 , Kawaguchi T 4 , Takahashi H 5 , Muthiah M 1 , Tan EXX 1 , Wijarnpreecha K 6 , Lee GH 1 , Noureddin M 7 , Lee BP 8 , Mathurin P 9 , Loomba R 10 , Huang DQ 1

Affiliations 

  • 1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • 2 Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
  • 3 School of Medicine, International Medical University, Kuala Lumpur, Malaysia
  • 4 Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  • 5 Liver Center, Saga Medical School, Saga University, Saga, Japan
  • 6 Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA
  • 7 Houston Research Institute, Houston, Texas, USA
  • 8 Division of Gastroenterology and Liver Diseases, University of Southern California, Los Angeles, California, USA
  • 9 Service des Maladies de l'appareil Digestif, Hôpital Huriez, CHU, Lille, France
  • 10 NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
Aliment Pharmacol Ther, 2024 Mar;59(6):730-741.
PMID: 38303565 DOI: 10.1111/apt.17888

Abstract

BACKGROUND: Although alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified.

AIMS: To determine the prevalence of alcohol abstinence, factors associated with alcohol abstinence and the impact of abstinence on morbidity and overall survival in people with alcohol-associated cirrhosis.

METHODS: We searched Medline and Embase from inception to 15 April 2023 for prospective and retrospective cohort studies describing alcohol abstinence in people with known alcohol-associated cirrhosis. Meta-analysis of proportions for pooled estimates was performed. The method of inverse variance, employing a random-effects model, was used to pool the hazard ratio (HR) comparing outcomes of abstinent against non-abstinent individuals with alcohol-associated cirrhosis.

RESULTS: We included 19 studies involving 18,833 people with alcohol-associated cirrhosis. The prevalence of alcohol abstinence was 53.8% (CI: 44.6%-62.7%). Over a mean follow-up duration of 48.6 months, individuals who continued to consume alcohol had significantly lower overall survival compared to those who were abstinent (HR: 0.611, 95% CI: 0.506-0.738). These findings remained consistent in sensitivity/subgroup analysis for the presence of decompensation, study design and studies that assessed abstinence throughout follow-up. Alcohol abstinence was associated with a significantly lower risk of hepatic decompensation (HR: 0.612, 95% CI: 0.473-0.792).

CONCLUSIONS: Alcohol abstinence is associated with substantial improvement in overall survival in alcohol-associated cirrhosis. However, only half of the individuals with known alcohol-associated cirrhosis are abstinent.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications