From the Guidelines
FibroScan can be used to monitor response to treatment in patients with Alcoholic Hepatitis (AH), but its results should be interpreted with caution, considering the potential impact of inflammation, cholestasis, or liver congestion on liver stiffness measurements. According to the most recent guidelines, non-invasive assessment of liver fibrosis is recommended in all patients with alcohol-related liver disease 1. The best-validated methods for assessing liver fibrosis in alcohol-related liver disease are elastography and specialized blood tests, with FibroScan being a recommended first-line option 1. However, it is essential to consider the specific thresholds of AST and bilirubin levels observed at the time of measurement when interpreting elastography results 1.
Some studies have shown that liver stiffness correlates with the degree of fibrosis in patients with ALD, but the presence of ASH can increase liver stiffness independently of fibrosis stage 1. Additionally, alcohol consumption may modify liver stiffness, with decreases in liver stiffness among abstainers and increases in relapsers 1. The American Gastroenterological Association Institute technical review also highlights the importance of timing when assessing liver stiffness in patients with chronic alcoholic liver disease, as inflammation can increase liver stiffness and lead to false elevations in VCTE readings 1.
When using FibroScan to monitor treatment response in AH, it is crucial to consider these factors and interpret the results in the context of clinical, imaging, and laboratory findings. The use of FibroScan as a monitoring tool should be part of a comprehensive approach, including regular clinical assessments and laboratory tests, to ensure accurate interpretation of the results and optimal patient management.
Key considerations for using FibroScan in this context include:
- Interpreting results in the context of clinical, imaging, and laboratory findings
- Considering the potential impact of inflammation, cholestasis, or liver congestion on liver stiffness measurements
- Using specialized blood tests, such as FibroTest or FibroMeter Alcohol, as an alternative or complementary option
- Regularly assessing AST and bilirubin levels to ensure accurate interpretation of elastography results
- Being aware of the potential for false elevations in liver stiffness due to ASH or other factors.
From the Research
Monitoring Response to Treatment in Alcoholic Hepatitis (AH)
There are no direct research papers provided that discuss the use of FibroScan (Fibrosis Scan) in monitoring response to treatment in patients with Alcoholic Hepatitis (AH).
Available Evidence on Alcoholic Hepatitis Treatment
- The provided studies discuss the treatment of Alcoholic Hepatitis (AH) using prednisolone and pentoxifylline, but do not mention the use of FibroScan for monitoring treatment response 2, 3, 4, 5, 6.
- These studies focus on the efficacy of corticosteroids and other treatments in improving survival rates and reducing mortality in patients with AH.
- The use of scoring systems, such as the Lille model and the Maddrey score, is discussed in the context of assessing disease severity and prognosis, but not in relation to FibroScan 2, 5.
- The provided evidence suggests that corticosteroids, such as prednisolone, may be effective in improving short-term survival in patients with severe AH, but does not address the role of FibroScan in monitoring treatment response 4, 6.
Limitations of Available Evidence
- The available studies do not provide information on the use of FibroScan for monitoring treatment response in AH patients.
- Further research is needed to determine the potential role of FibroScan in this context.