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  • Year in Review
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ALD in 2023

Novel interventions against alcohol-related liver disease

Nature Reviews Gastroenterology & Hepatology volume 21, pages 78–79 (2024)Cite this article

Subjects

In 2023, there were significant advancements in trials of interventions to reduce mortality and morbidity from alcohol-related liver disease, spanning the entire spectrum of disease: primary prevention to reduce overall alcohol-related harm, secondary prevention to attenuate fibrosis progression and tertiary prevention using antibiotics for severe alcohol-associated hepatitis.

Key advances

  • Thirty-two months after implementation of a £0.50 minimum price for a unit of alcohol in Scotland, mortality wholly attributable to alcohol consumption decreased by 13%, in large part driven by a 12% reduction in deaths due to alcohol-related liver disease. The most socioeconomically deprived areas observed the largest improvements5.

  • The gut-selective antibiotic rifaximin-α did not reduce fibrosis stage compared with placebo after 18 months of treatment in a randomized controlled trial of patients with alcohol-related fibrosis, but it did prevent fibrosis worsening, possibly by attenuating hepatic inflammation6.

  • Prophylactic amoxicillin–clavulanate led to an absolute risk reduction of 4.7% for infections in patients with severe alcohol-associated hepatitis treated with glucocorticoids but did not improve 2-month survival. This finding does not support the use of prophylactic antibiotics in patients with severe alcohol-associated hepatitis10.

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Fig. 1: Prevention strategies to improve the life and health of patients at risk for alcohol-related liver disease.

References

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Author information

Authors and Affiliations

  1. FLASH Center for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark

    Maja Thiele

  2. Department for Clinical Medicine, University of Southern Denmark, Odense, Denmark

    Maja Thiele

  3. Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium

    Christophe Moreno

  4. Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium

    Christophe Moreno

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  1. Maja Thiele
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Corresponding author

Correspondence to Maja Thiele.

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Competing interests

M.T. reports speaker fees from Echosens, Siemens, Norgine, Tillotts, Takeda and Madrigal; advisory fees from GE Healthcare, Boehringer Ingelheim and GSK; is a co-founder and board member of Evido.health; and is funded by grants from the Novo Nordisk Foundation (DECIDE, NNF 20OC0059393) and Horizon2020 (GALAXY, grant number 668031; LiverScreen, grant number 847989; MicrobPredict, grant number 825694). C.M. reports speaker fees from Echosens, Julius Clinical, Gilead Sciences and Surrozen.

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Thiele, M., Moreno, C. Novel interventions against alcohol-related liver disease. Nat Rev Gastroenterol Hepatol 21, 78–79 (2024). https://doi.org/10.1038/s41575-023-00877-x

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