EASL Clinical Practical Guidelines: Management of Alcoholic Liver Disease

发表于：Journal of Hepatology · 年份：2012 · DOI：10.1016/j.jhep.2012.04.004 · 被引用次数：732 · 研究领域：Liver Disease Diagnosis and Treatment、Alcohol Consumption and Health Effects、Diet, Metabolism, and Disease

Alcoholic liver disease (ALD) is the most prevalent cause of advanced liver disease in Europe. However, there has been limited research investment into ALD despite its significant burden on the health of Europeans. This disparity is reflected by the ETOh score – the ratio of the estimated population mortality rate to the number of trials focused on a particular disease. The ETOh score for ALD is 358, compared with 1.4 for hepatitis B, 4.9 for hepatitis C, and 15.2 for primary biliary cirrhosis. In recent years however, the mechanisms driving disease progression and the natural history of ALD have been better defined and novel targets for therapy have been identified. In addition, significant clinical research has produced a clear framework for the evaluation of new therapies in particular in patients with alcoholic steatohepatitis (ASH). ALD is a complex disease, the successful management of which hinges on the integration of all the competences in public health, epidemiology, addiction behavior and alcohol-induced organ injury. Both primary intervention to reduce alcohol abuse and secondary intervention to prevent alcohol-associated morbidity and mortality rely on the coordinated action of multidisciplinary teams established at local, national, and international levels. These guidelines are largely based on the issues raised during the EASL monothematic conference on ALD held in Athens in 2010. The guidelines have three main aims: (1) to provide physicians with clinical reco...