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An RCT of 174 patients with severe alcoholic hepatitis found that the combination of prednisolone + NAC (IV for 5 days, then oral for 2 weeks) significantly reduced 1-month mortality compared to prednisolone alone (8% vs 24%, p=0.006), though the difference was not significant at 6 months (Nguyen-Khac et al., N Engl J Med, 2011) [36]

The scientific interest in this combination stems from the possibility of observing, in controlled experimental models, complementary biological pathways involved in cellular migration, stress response, actin dynamics, and structural repair processes

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