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- W2900754906 abstract "Background Lactulose is recommended as secondary prophylaxis after the initial episode and rifaximin as an add-on to lactulose for preventing recurrent episodes of hepatic encephalopathy (HE) after the second episode. However, the relative merits of rifaximin vs nonabsorbable disaccharides (NADs) on overt and minimal HE (MHE) are debated. Aim This study aimed to perform a meta-analysis of randomised controlled trials (RCTs) on rifaximin vs NADs in HE. Methods Electronic and manual searches were performed. The results presented as risk ratios or standardised mean difference with 95% confidence intervals. Sensitivity analyses were performed to evaluate the risk of bias and sources of heterogeneity. Results In total, 8 RCTs were included, and only 7 RCTs with 386 patients were merged for meta-analysis. Meta-analyses showed that rifaximin appears better at reducing the blood ammonia levels compared with NADs, and that both rifaximin and NADs were well tolerated with few adverse effects. There were however, no significant differences in clinical efficacy or ability to reverse MHE between the two treatments. Most of the included studies were of low quality with a high risk of bias, leading to a low statistical power. Conclusions Rifaximin had a beneficial effect on blood ammonia levels compared with NADs, and both rifaximin and NADs have good tolerance. However, no difference in the clinical efficacy and MHE reversal was observed between them." @default.
- W2900754906 created "2018-11-29" @default.
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- W2900754906 date "2018-11-19" @default.
- W2900754906 modified "2023-09-27" @default.
- W2900754906 title "Effects of rifaximin versus nonabsorbable disaccharides in hepatic encephalopathy" @default.
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- W2900754906 doi "https://doi.org/10.1002/ygh2.207" @default.
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