Area Editoriale
BACKGROUND: Alcohol is one of themost common causes of liver disease in the Western World. Randomised clinicaltrials have examined the effects of anabolic-androgenic steroids for alcoholicliver disease. OBJECTIVES: To assess the beneficial and harmful effects ofanabolic-androgenic steroids for patients with alcoholic liver disease based onthe results of randomised clinical trials. SEARCH STRATEGY: We searched TheCochrane Hepato-Biliary Group Controlled Trials Register, The CochraneControlled Trials Register in The Cochrane Library, MEDLINE, EMBASE, LILACS, andScience Citation Index Expanded until June 2006. Electronic searches werecombined with full text searches. Manufacturers and researchers in the fieldwere also contacted. SELECTION CRITERIA: Randomised clinical trials studyingpatients with alcoholic steatosis, alcoholic fibrosis, alcoholic hepatitis,and/or alcoholic cirrhosis were included. Interventions encompassedanabolic-androgenic steroids at any dose or duration versus placebo or nointervention. The trials could be double blind, single blind, or unblinded. Thetrials could be unpublished or published, and no language limitations wereapplied. DATA COLLECTION AND ANALYSIS: Outcomes are assessed at maximalfollow-up. All analyses were performed according to the intention-to-treatmethod. The statistical package RevMan Analyses was used. The methodologicalquality of the randomised clinical trials was assessed. MAIN RESULTS: Combiningthe results of five randomised clinical trials randomising 499 patients withalcoholic hepatitis and/or cirrhosis demonstrated no significant effects ofanabolic-androgenic steroids on mortality (relative risk (RR) 1.01, 95%confidence interval (CI) 0.79 to 1.29), liver-related mortality (RR 0.83, 95%CI 0.60 to 1.15), complications of liver disease (RR 1.25, 95% CI 0.74 to2.10), and liver histology. Anabolic-androgenic steroids did not significantlyaffect a number of other outcome measures, including sexual function and liverbiochemistry. Anabolic-androgenic steroids were not associated with asignificantly increased risk of non-serious adverse events (RR 1.14, 95% CI0.50 to 2.59) or with serious adverse events (RR 4.54, 95% CI 0.57 to 36.30).AUTHORS' CONCLUSIONS: This systematic review could not demonstrate anysignificant beneficial effects of anabolic-androgenic steroids on anyclinically important outcomes (mortality, liver-related mortality, livercomplications, and histology) of patients with alcoholic liver disease.Leggil'articolo:è full text!