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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2025; 31(35): 109987
Published online Sep 21, 2025. doi: 10.3748/wjg.v31.i35.109987
Published online Sep 21, 2025. doi: 10.3748/wjg.v31.i35.109987
Beyond corticosteroids: A systematic review of novel therapeutic strategies in severe alcoholic hepatitis and 90-day survival
Marta Quiñones-Calvo, Rubén Alvarado-Jara, Paula García-Renedo, Conrado M Fernández-Rodríguez, Department of Gastroenterology, Hospital Universitario Fundación Alcorcón, Alcorcón 28922, Madrid, Spain
Marta Quiñones-Calvo, Escuela Internacional de Doctorado, Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón 28922, Madrid, Spain
Elena Stallings, Unidad de Bioestadística Clínica, Instituto Ramón y Cajal de Investigación Sanitaria, CIBERESP, Hospital Universitario Ramón y Cajal, Madrid 28034, Madrid, Spain
Eulalia Grifol-Clar, Health Librarian, Hospital Universitario Fundación Alcorcón, Alcorcón 28922, Madrid, Spain
Conrado M Fernández-Rodríguez, Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Alcorcón 28922, Madrid, Spain
Co-corresponding authors: Marta Quiñones-Calvo and Conrado M Fernández-Rodríguez.
Author contributions: Quiñones-Calvo M contributed by participating in every stage of the systematic review: Research question development, search strategy design across the different data sources, establishment of the inclusion and exclusion criteria, protocol development and registration, study selection, data extraction and finally, qualitative analysis and critical appraisal. As the first author, she also serves as a corresponding author. Alvarado-Jara R contributed by independently performing the study selection with Quiñones-Calvo M. Furthermore, he performed data extraction, qualitative analysis, and critical appraisal with Quiñones-Calvo M and García-Renedo P. García-Renedo P performed data extraction, qualitative analysis, and critical appraisal with Quiñones-Calvo M and Alvarado-Jara R. Stallings E is one of the methodological experts and was involved in protocol development and registration. Furthermore, she supervised the correct use of tools for identifying risk of bias in the critical appraisal and ensured methodological quality of this review in accordance with “Preferred Reporting Items for Systematic and Meta-Analyses” statement, apart from participating in the development of the results synthesis. The manuscript underwent comprehensive language polishing by her as a native English speaker, with specific attention to vocabulary and grammatical consistency. Grifol-Clar E is the health librarian. She helped with the the search strategy design. Fernández-Rodríguez CM helped achieve consensus between reviewers if needed at any stage of the systematic review and participated in the critical appraisal. He is designated as a corresponding author, as he was invited by the journal to write the manuscript. All authors have read and approved the final manuscript.
Supported by Hepatology Training Grant from the Spanish Association for The Study of Liver (AEEH-Asociación Española para el Estudio del Hígado) in 2023, No. G28551570 (to Quiñones-Calvo M).
Conflict-of-interest statement: The authors declare no conflicts of interest related to this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marta Quiñones-Calvo, MD, Department of Gastroenterology, Hospital Universitario Fundación Alcorcón, Avenida Budapest 1, Alcorcón 28922, Madrid, Spain.
Received: May 28, 2025
Revised: June 20, 2025
Accepted: August 13, 2025
Published online: September 21, 2025
Processing time: 113 Days and 18.6 Hours
Revised: June 20, 2025
Accepted: August 13, 2025
Published online: September 21, 2025
Processing time: 113 Days and 18.6 Hours
Core Tip
Core Tip: Severe alcoholic hepatitis (SAH) is associated with high mortality, yet effective mid-term treatments remain limited. This systematic review exclusively examines survival or mortality at 90 days, synthesizing evidence from eight recent studies. While corticosteroids remain the mainstay of current therapy, their survival benefit appears confined to the first 28 days. In contrast, interventions such as Fecal Microbiota Transplantation and granulocyte colony-stimulating factor have emerged as promising approaches for improving 90-day survival, though further validation is needed. This review highlights the urgent need for innovative therapies and high-quality trials to address mid-term survival in SAH, a critical but underexplored therapeutic window.