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Medicine Protects Livers of Alcoholics Who Keep Drinking

December 2, 1987

BOSTON (AP) _ A widely available medicine appears to significantly protect alcoholics from fatal liver disease, even when they continue to drink moderately, a study has found.

The drug, called propylthiouracil or PTU, cut the death rate in half among alcoholics who took it over two years, and it was almost completely effective among those who drank the least.

Experts cautioned the medicine doesn’t allow people to drink heavily, and the best way to avoid liver disease still is to give up alcohol.

Ordinarily, PTU is used to treat overactive thyroid glands. Researchers at the Addiction Research Foundation in Toronto found that it also seems to protect the liver from the poisonous effects of alcohol.

An estimated 18 million Americans have serious drinking problems, and liver disease is a common cause of death among them.

″In the long term, it looks like PTU is beneficial to patients, even though they continue to drink,″ said Dr. Jerome Zeldis of Boston’s Beth Israel Hospital. ″I’m very much tempted to try it on a few patients.″

However, he and Dr. Thomas LaMont of Boston University School of Medicine noted that the drug didn’t help people who drank heavily.

″The current management of anyone with any complications of alcoholism is to stop drinking completely forever,″ said LaMont. ″The public has to hear that, because this could be used as a crutch to continue drinking.″

The study, directed by Dr. Hector Orrego, was published in Thursday’s New England Journal of Medicine.

The researchers studied 310 alcoholics who had cirrhosis and other liver disease caused by drinking. When they entered the program, they drank at least the equivalent of eight ounces of whiskey a day or went on frequent binges. During the two-year study, half took PTU pills twice a day, while the rest got dummy pills.

Nearly all the men and women continued to drink. When the study was over, 13 percent of the PTU patients had died, compared with 25 percent of the comparison group. Those who drank less did better.

The researchers measured alcohol levels in their urine and divided the patients into high- and low-drinking categories. The death rate was 3 percent for low drinkers who took PTU and 25 percent for low drinkers who got dummy pills. It was 22 percent for high drinkers who got PTU and 26 percent for those in the high-drinking comparison group.

The researchers did not specify how much the people in the two groups actually drank while enrolled in the study.

The treatment, developed at the Toronto foundation over the last 15 years, has been controversial, in part because a study five years ago at the University of Southern California did not show any benefits of the medicine.

Dr. Telfer Reynolds, a co-author of the earlier study, said, ″It’s hard to explain how we got such negative findings, and they got positive findings.″

However, he noted that patients in his study were hospitalized and did not drink, while those in the Toronto program continued drinking. ″It’s possible that the drug does good in preventing the toxicity of alcohol rather than in improving the liver once the damage has occurred,″ Reynolds said.

For this reason, experts are uncertain whether the medicine would help alcoholics who have stopped drinking. Such people continue to be at risk from liver disease.

Zeldis said, ″I don’t think this is ready to become part of the standard therapy for alcoholic liver disease until another group with a large number of patients verifies their findings.″

The study turned up no serious side effects. Dr. Markku Linnoila, clinical director of the National Institute on Alcohol Abuse and Alcoholism, said larger studies will be needed to find possible adverse reactions to the drug.

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