Landmark Trials

Question 1

What was the outcome of the ALF 2009 trial?

Answer 1

IV NAC shown to improve transplant free survival in patients with early non-paracetamol related acute liver failure.
Late stage disease did not improve with IV NAC.

Question 2

What was the outcome of the BISAP trial of 2009?

Answer 2

Five point scoring system for patients with acute pancreatitis to identify those at increased risk for mortality.

Question 3

What was the outcome of the early combined vs conventional mx in Crohn’s trial?

Answer 3

Lancet 2008.
Initiation of more intensive therapy early in Crohn’s more likely to result in corticosteroid free remission than conventional therapy.

Question 4

Outcome of the FAMOUS trial of 2009?

Answer 4

Lancet 2009.
Famotidine effective in preventing gastric and duodenal ulcers and erosive oesophagitis in patients receiving low dose ASA therapy.

Question 5

Outcome of glucorticoids and NAC in alcoholic hepatitis trial?

Answer 5

NEJM 2011.

Combination therapy improved 1/12 survival, but not 6/12 survival compared to prednisolone mono therapy.

Question 6

Outcome of MELD 2003 trial?

Answer 6

MELD score can be applied for allocation of donor livers as it accurately predicts 3mo mortality in patients with chronic liver failure.

Question 7

Outcome of SONIC 2010 trial?

Answer 7

NEJM 2010.
Mod-severe Crohn’s more likely to result in corticosteroid free admission if infliximab + azathioprine combine (cf inflix mono therapy).