Work

Integrating Phosphatidylethanol to Enhance Alcohol Quantification in Steatotic Liver Disease and Clinical Trials

Year: 2025

Type: article

Abstract: Accurate quantification of alcohol intake is essential for the diagnosis, subclassification, and management of steatotic liver disease (SLD). In everyday clinical practice, alcohol histories rely primarily on physician-assisted self-report, with validated questionnaires used variably. Both provider-level inconsistencies in documentation and patient-level factors (e.g., recall and social-desirability biases) can contribute to misclassification of SLD subtypes. Phosphatidylethanol (PEth), a direct alcohol biomarker detectable for ~2-4 weeks, has emerged as a promising objective tool that can complement self-report. Across diverse SLD populations, PEth consistently uncovers underreported alcohol use, sharpens subclassification, informs prognosis, and enables longitudinal monitoring to guide care. In liver transplantation, PEth supports documentation of abstinence and detection of relapse to enable timely intervention. This mini-review synthesises current evidence on PEth in SLD, emphasises its value in both clinical and research settings, and outlines priorities for integrating PEth into structured care pathways and clinical trial design to improve outcomes and harmonise endpoints.

Source: Liver International

DOI: 10.1111/liv.70489

Authors: Elias D. Rady, Thomas G. Cotter

Institution: The University of Texas Southwestern Medical Center

Language: English

Topic: Alcohol Consumption and Health Effects

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,780