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PROPYLTHIOURACIL: PROMISING TREATMENT FOR ALCOHOLIC LIVER DISEASE.

Experiments in animals have shown that propylthiouracil (PTU) can protect against hypoxic and toxic liver injury, and studies in humans have suggested that PTU can lead to more rapid improvement in patients with alcoholic liver disease.

In a long-term, double-blind, randomized trial of 310 compliant patients who were treated for up to 2 years, PTU led to a 62 percent reduction in mortality. The benefit of PTU was most pronounced in alcoholic patients who were most severely affected by liver disease at the start of the study. Patients who continued to drink most heavily were the least likely to benefit from PTU therapy.

The dose of PTU used was low (300 mg per day), and the drug did not produce clinical hypothyroidism. The incidence of side effects that could be attributed to PTU was not significantly different between the two groups. More than half the patients in each group had dropped out of the study after two years.

PTU may offer a promising new approach to reducing the morbidity and mortality of alcoholic liver disease, but long-term compliance with this (or any other) regimen will be difficult in this group of patients.

— ALK

Published in Journal Watch General Medicine December 8, 1987

Citation(s):

Orrego H; Blake J E; Blendis L M; Compton K V; Israel Y. Long-term treatment of alcoholic liver disease with propylthiouracil. N Engl J Med 1987 Dec 3 317 1421-1427.

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