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Meta‐analysis: Prevalence and impact of alcohol abstinence in alcohol‐associated cirrhosis
- 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 XX;
- Wijarnpreecha, Karn;
- Lee, Guan Huei;
- Noureddin, Mazen;
- Lee, Brian P;
- Mathurin, Philippe;
- Loomba, Rohit;
- Huang, Daniel Q
- et al.
Published Web Location
https://doi.org/10.1111/apt.17888Abstract
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.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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