Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis
Although alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified. To determine the prevalence of alcohol abstinence, factors associated with alcohol abstinence and the impact of abstinence...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2024-03, Vol.59 (6), p.730-741 |
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| creator | Lim, Wen Hui Tay, Phoebe Ng, Cheng Han Tan, Darren Jun Hao Ong, Christen Koh, Jia Hong Teng, Margaret Chee, Douglas Wong, Zhen Yu Kawaguchi, Takumi Takahashi, Hirokazu Muthiah, Mark Tan, Eunice X X Wijarnpreecha, Karn Lee, Guan Huei Noureddin, Mazen Lee, Brian P Mathurin, Philippe Loomba, Rohit Huang, Daniel Q |
| description | Although alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified.
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.
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.
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).
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. |
| doi_str_mv | 10.1111/apt.17888 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11371415</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2931156898</sourcerecordid><originalsourceid>FETCH-LOGICAL-c244t-a9c974c0708456f28ce75866e70d6d32335fcbd2449bd4bb9f5d01752c542cfb3</originalsourceid><addsrcrecordid>eNpd0ctKAzEUBuAgiq2XhS8gA250MTWXSSZxI1K8gaIL3bgJZzIZG5lOajIt9O2NtoqaTSD5-DmcH6EDgkcknVOY9SNSSik30JAwwXOKmdhEQ0yFyqkkbIB2YnzDGIsS0200YJJhxgUfopd720MOHbTL6OJZ9hjsAlrbGZtBV2duOgPTZ77JoDV-4tsMqti77gu47vs1hxi9cdDbOjMuhIlPYXtoq4E22v31vYuery6fxjf53cP17fjiLje0KPoclFFlYXCJZcFFQ6WxJZdC2BLXomaUMd6Yqk5WVXVRVarhNSYlp4YX1DQV20Xnq9zZvJra2tiuD9DqWXBTCEvtwem_P52b6Fe_0ISwkhSEp4TjdULw73Mbez110di2hc76edRUUao4JYolevSPvvl5SOv7VIwQLqSSSZ2slAk-xmCbn2kI1p-V6VSZ_qos2cPf4__I747YBzuekn0</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2931156898</pqid></control><display><type>article</type><title>Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Lim, Wen Hui ; Tay, Phoebe ; Ng, Cheng Han ; Tan, Darren Jun Hao ; Ong, Christen ; Koh, Jia Hong ; Teng, Margaret ; Chee, Douglas ; Wong, Zhen Yu ; Kawaguchi, Takumi ; Takahashi, Hirokazu ; Muthiah, Mark ; Tan, Eunice X X ; Wijarnpreecha, Karn ; Lee, Guan Huei ; Noureddin, Mazen ; Lee, Brian P ; Mathurin, Philippe ; Loomba, Rohit ; Huang, Daniel Q</creator><creatorcontrib>Lim, Wen Hui ; Tay, Phoebe ; Ng, Cheng Han ; Tan, Darren Jun Hao ; Ong, Christen ; Koh, Jia Hong ; Teng, Margaret ; Chee, Douglas ; Wong, Zhen Yu ; Kawaguchi, Takumi ; Takahashi, Hirokazu ; Muthiah, Mark ; Tan, Eunice X X ; Wijarnpreecha, Karn ; Lee, Guan Huei ; Noureddin, Mazen ; Lee, Brian P ; Mathurin, Philippe ; Loomba, Rohit ; Huang, Daniel Q</creatorcontrib><description>Although alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified.
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.
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.
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).
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.</description><identifier>ISSN: 0269-2813</identifier><identifier>ISSN: 1365-2036</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.17888</identifier><identifier>PMID: 38303565</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Abstinence ; Alcohol ; Alcohol Abstinence ; Cirrhosis ; Humans ; Liver cirrhosis ; Liver Cirrhosis, Alcoholic - complications ; Liver Cirrhosis, Alcoholic - epidemiology ; Medical prognosis ; Meta-analysis ; Morbidity ; Prevalence ; Prospective Studies ; Retrospective Studies ; Survival</subject><ispartof>Alimentary pharmacology & therapeutics, 2024-03, Vol.59 (6), p.730-741</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><rights>Copyright © 2024 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c244t-a9c974c0708456f28ce75866e70d6d32335fcbd2449bd4bb9f5d01752c542cfb3</cites><orcidid>0000-0003-2127-2040 ; 0000-0002-5165-5061 ; 0000-0002-4845-9991 ; 0000-0002-8297-1569 ; 0000-0002-6232-6343 ; 0000-0002-9724-4743</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38303565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lim, Wen Hui</creatorcontrib><creatorcontrib>Tay, Phoebe</creatorcontrib><creatorcontrib>Ng, Cheng Han</creatorcontrib><creatorcontrib>Tan, Darren Jun Hao</creatorcontrib><creatorcontrib>Ong, Christen</creatorcontrib><creatorcontrib>Koh, Jia Hong</creatorcontrib><creatorcontrib>Teng, Margaret</creatorcontrib><creatorcontrib>Chee, Douglas</creatorcontrib><creatorcontrib>Wong, Zhen Yu</creatorcontrib><creatorcontrib>Kawaguchi, Takumi</creatorcontrib><creatorcontrib>Takahashi, Hirokazu</creatorcontrib><creatorcontrib>Muthiah, Mark</creatorcontrib><creatorcontrib>Tan, Eunice X X</creatorcontrib><creatorcontrib>Wijarnpreecha, Karn</creatorcontrib><creatorcontrib>Lee, Guan Huei</creatorcontrib><creatorcontrib>Noureddin, Mazen</creatorcontrib><creatorcontrib>Lee, Brian P</creatorcontrib><creatorcontrib>Mathurin, Philippe</creatorcontrib><creatorcontrib>Loomba, Rohit</creatorcontrib><creatorcontrib>Huang, Daniel Q</creatorcontrib><title>Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Although alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified.
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.
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.
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).
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.</description><subject>Abstinence</subject><subject>Alcohol</subject><subject>Alcohol Abstinence</subject><subject>Cirrhosis</subject><subject>Humans</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis, Alcoholic - complications</subject><subject>Liver Cirrhosis, Alcoholic - epidemiology</subject><subject>Medical prognosis</subject><subject>Meta-analysis</subject><subject>Morbidity</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Survival</subject><issn>0269-2813</issn><issn>1365-2036</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0ctKAzEUBuAgiq2XhS8gA250MTWXSSZxI1K8gaIL3bgJZzIZG5lOajIt9O2NtoqaTSD5-DmcH6EDgkcknVOY9SNSSik30JAwwXOKmdhEQ0yFyqkkbIB2YnzDGIsS0200YJJhxgUfopd720MOHbTL6OJZ9hjsAlrbGZtBV2duOgPTZ77JoDV-4tsMqti77gu47vs1hxi9cdDbOjMuhIlPYXtoq4E22v31vYuery6fxjf53cP17fjiLje0KPoclFFlYXCJZcFFQ6WxJZdC2BLXomaUMd6Yqk5WVXVRVarhNSYlp4YX1DQV20Xnq9zZvJra2tiuD9DqWXBTCEvtwem_P52b6Fe_0ISwkhSEp4TjdULw73Mbez110di2hc76edRUUao4JYolevSPvvl5SOv7VIwQLqSSSZ2slAk-xmCbn2kI1p-V6VSZ_qos2cPf4__I747YBzuekn0</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Lim, Wen Hui</creator><creator>Tay, Phoebe</creator><creator>Ng, Cheng Han</creator><creator>Tan, Darren Jun Hao</creator><creator>Ong, Christen</creator><creator>Koh, Jia Hong</creator><creator>Teng, Margaret</creator><creator>Chee, Douglas</creator><creator>Wong, Zhen Yu</creator><creator>Kawaguchi, Takumi</creator><creator>Takahashi, Hirokazu</creator><creator>Muthiah, Mark</creator><creator>Tan, Eunice X X</creator><creator>Wijarnpreecha, Karn</creator><creator>Lee, Guan Huei</creator><creator>Noureddin, Mazen</creator><creator>Lee, Brian P</creator><creator>Mathurin, Philippe</creator><creator>Loomba, Rohit</creator><creator>Huang, Daniel Q</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2127-2040</orcidid><orcidid>https://orcid.org/0000-0002-5165-5061</orcidid><orcidid>https://orcid.org/0000-0002-4845-9991</orcidid><orcidid>https://orcid.org/0000-0002-8297-1569</orcidid><orcidid>https://orcid.org/0000-0002-6232-6343</orcidid><orcidid>https://orcid.org/0000-0002-9724-4743</orcidid></search><sort><creationdate>20240301</creationdate><title>Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis</title><author>Lim, Wen Hui ; Tay, Phoebe ; Ng, Cheng Han ; Tan, Darren Jun Hao ; Ong, Christen ; Koh, Jia Hong ; Teng, Margaret ; Chee, Douglas ; Wong, Zhen Yu ; Kawaguchi, Takumi ; Takahashi, Hirokazu ; Muthiah, Mark ; Tan, Eunice X X ; Wijarnpreecha, Karn ; Lee, Guan Huei ; Noureddin, Mazen ; Lee, Brian P ; Mathurin, Philippe ; Loomba, Rohit ; Huang, Daniel Q</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c244t-a9c974c0708456f28ce75866e70d6d32335fcbd2449bd4bb9f5d01752c542cfb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abstinence</topic><topic>Alcohol</topic><topic>Alcohol Abstinence</topic><topic>Cirrhosis</topic><topic>Humans</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis, Alcoholic - complications</topic><topic>Liver Cirrhosis, Alcoholic - epidemiology</topic><topic>Medical prognosis</topic><topic>Meta-analysis</topic><topic>Morbidity</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lim, Wen Hui</creatorcontrib><creatorcontrib>Tay, Phoebe</creatorcontrib><creatorcontrib>Ng, Cheng Han</creatorcontrib><creatorcontrib>Tan, Darren Jun Hao</creatorcontrib><creatorcontrib>Ong, Christen</creatorcontrib><creatorcontrib>Koh, Jia Hong</creatorcontrib><creatorcontrib>Teng, Margaret</creatorcontrib><creatorcontrib>Chee, Douglas</creatorcontrib><creatorcontrib>Wong, Zhen Yu</creatorcontrib><creatorcontrib>Kawaguchi, Takumi</creatorcontrib><creatorcontrib>Takahashi, Hirokazu</creatorcontrib><creatorcontrib>Muthiah, Mark</creatorcontrib><creatorcontrib>Tan, Eunice X X</creatorcontrib><creatorcontrib>Wijarnpreecha, Karn</creatorcontrib><creatorcontrib>Lee, Guan Huei</creatorcontrib><creatorcontrib>Noureddin, Mazen</creatorcontrib><creatorcontrib>Lee, Brian P</creatorcontrib><creatorcontrib>Mathurin, Philippe</creatorcontrib><creatorcontrib>Loomba, Rohit</creatorcontrib><creatorcontrib>Huang, Daniel Q</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lim, Wen Hui</au><au>Tay, Phoebe</au><au>Ng, Cheng Han</au><au>Tan, Darren Jun Hao</au><au>Ong, Christen</au><au>Koh, Jia Hong</au><au>Teng, Margaret</au><au>Chee, Douglas</au><au>Wong, Zhen Yu</au><au>Kawaguchi, Takumi</au><au>Takahashi, Hirokazu</au><au>Muthiah, Mark</au><au>Tan, Eunice X X</au><au>Wijarnpreecha, Karn</au><au>Lee, Guan Huei</au><au>Noureddin, Mazen</au><au>Lee, Brian P</au><au>Mathurin, Philippe</au><au>Loomba, Rohit</au><au>Huang, Daniel Q</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>59</volume><issue>6</issue><spage>730</spage><epage>741</epage><pages>730-741</pages><issn>0269-2813</issn><issn>1365-2036</issn><eissn>1365-2036</eissn><abstract>Although alcohol abstinence may be an effective intervention for alcohol-associated cirrhosis, its association with prognosis has not been systematically assessed or quantified.
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.
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.
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).
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.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38303565</pmid><doi>10.1111/apt.17888</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-2127-2040</orcidid><orcidid>https://orcid.org/0000-0002-5165-5061</orcidid><orcidid>https://orcid.org/0000-0002-4845-9991</orcidid><orcidid>https://orcid.org/0000-0002-8297-1569</orcidid><orcidid>https://orcid.org/0000-0002-6232-6343</orcidid><orcidid>https://orcid.org/0000-0002-9724-4743</orcidid></addata></record> |
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| subjects | Abstinence Alcohol Alcohol Abstinence Cirrhosis Humans Liver cirrhosis Liver Cirrhosis, Alcoholic - complications Liver Cirrhosis, Alcoholic - epidemiology Medical prognosis Meta-analysis Morbidity Prevalence Prospective Studies Retrospective Studies Survival |
| title | Meta-analysis: Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis |
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