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While nonsevere AH usually responds to alcohol abstinence, severe AH, identified by Maddrey scoring \u2265 32, has a bad prognosis and is traditionally treated by a 28\u2010day course of prednisone therapy. A recent trial, which showed no improvement of long\u2010term survival but significant reduced mortality after 28 days of corticoid therapy compared to placebo, opens a debate on its efficacy. <jats:italic>N<\/jats:italic>\u2010acetyl\u2010cysteine supplementation combined with steroid therapy is also able to reduce the 28\u2010day mortality compared to steroid alone. While guidelines recommend high\u2010calorie intake and protein supplementation in decompensated liver diseases, intensive enteral nutrition together with corticoid treatment does not reduce mortality compared to corticoid alone in a recent study with ASH patients. Stimulation of liver regeneration through interleukin\u201022, granulocyte colony\u2010stimulating factor or farnesoid X receptor agonists, inhibition of apoptosis, early liver transplantation and modulation of gut microbiota through antibiotic or faecal transplantation approaches constitute new therapeutic perspectives that are investigated in current clinical trials. Inhibition of oxidative stress, modulation of gut fungal populations and stimulation of progenitor cell proliferation and pro\u2010regenerative inflammatory pathways constitute prospects for future human trials. For long\u2010term survival, strategies for persistent alcohol abstinence remain the key of success, opening another large research field.<\/jats:p>","DOI":"10.1111\/eci.12767","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T10:38:42Z","timestamp":1495103922000},"page":"531-539","source":"Crossref","is-referenced-by-count":27,"title":["Treatment of severe alcoholic hepatitis: past, present and future"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7651-9314","authenticated-orcid":false,"given":"Nicolas","family":"Lanthier","sequence":"first","affiliation":[{"name":"Service d'H\u00e9pato\u2010gastroent\u00e9rologie Cliniques universitaires Saint\u2010Luc Universit\u00e9 Catholique de Louvain Brussels Belgium"},{"name":"Laboratory of Hepatogastroenterology Institut de Recherche Exp\u00e9rimentale et Clinique Universit\u00e9 catholique de Louvain Brussels 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