Use of colchicine and steroids in the treatment of alcoholic liver disease.

To date, only one group has reported its clinical experience with colchicine therapy. This study included a randomized clinical trial of 22 patients and an open study of 53 patients. The beneficial effect of 1 mg colchicine daily for five days a week has been promising but not convincing. Corticosteroid therapy for the treatment of alcoholic hepatitis was evaluated in nine short-term randomized clinical trials that included 150 treated and 161 control patients with a mortality rate of 37 and 44%, respectively. In these studies, encephalopathy was present in 80 treated and 76 control patients with a mortality rate of 59 and 74%, respectively. None of these differences is significant. The studies did document that patients with mild disease require no specific therapy besides abstinence and general supportive measures; those with severe disease showed a trend toward better survival on corticosteroid therapy. This trend was strong in the earlier publications, but was absent in the most recent studies, which included the largest numbers of patients.