prednisone + metadoxine

A combination therapy consisting of prednisone (a glucocorticoid) and metadoxine (an antioxidant). This combination has been studied primarily for treating severe alcoholic hepatitis, where it has shown significant improvements in short-term survival rates compared to prednisone monotherapy. The addition of metadoxine to standard prednisone treatment has been demonstrated to improve 30-day survival (74.3% vs 45.7%) and 90-day survival (68.6% vs 20.0%) in patients with severe alcoholic hepatitis. The combination also reduces the development or progression of hepatic encephalopathy and hepatorenal syndrome. Metadoxine's multifactorial mechanism of action includes antioxidant properties, protection of hepatocytes by increasing ATP, reduction of free fatty acid accumulation, and inhibition of TNF-α.