Incidence and efficacy of strategies for preventing hepatic encephalopathy following transjugular intrahepatic portosystemic shunt: A meta-analysis

Table 3 Relevant information included in the literature

Ref.	Country	Study type/medication situation	History of HE (present/absent)	Group/treatment/events	Age	Sex (male/female)	Etiology of liver disease	MELD/Child-Pugh score/Child-Pugh grade	Indication for TIPS (bleeding/ascites/both)	Stent type (covered/uncovered)
Riggio et al[35], 2005	Italy	RCT; LM: 600 mg QD × 1 month; RM 1200 mg QD × 1 month	LM: 4/21; RM: 3/22; NM: 2/23	n = 75; 1 month; LM (n = 9/25); RM (n = 8/25); NM (n = 8/25)	LM: 60.6 ± 9; RM: 55 ± 10.8; NM: 54.9 ± 11.7	LM: 14/11; RM: 14/11; NM: 21/4	Alcoholic/non-alcoholic; LM: 12/13; RM: 6/19; NM: 7/18	LM: 7.6 ± 3.9/8.1 ± 1.6/6, 13, 6; RM: 10.7 ± 6/8.1 ± 1.8/5, 14, 6; NM: 8.4 ± 5.2/7.3 ± 1.6/9, 15, 1	LM: 15/10/0; RM: 17/8/0; NM: 18/7/0	0/75
Bass et al[36], 2010	America	RCT; RM: 550 mg; BID × 6 months	299/0	n = 299 (n = 32 undergoing TIPS) 6 months; RM (1/12); NM (7/20)	RM: 55.5 ± 9.6; NM: 56.8 ± 9.2	RM: 75/75; NM: 107/52	NA	MELD ≤ 10/MELD 11-18/MELD 19-24 RM: 34/94/12; NM: 48/96/14	NA	NA
Bai et al[37], 2014	China	RCT; LOLA: 30 mg QD × 7 days	0/40	n = 40; 1 week; LOLA (n = 1/21); NM (n = 3/19)	LOLA: 49.71 ± 10.07; NM: 45.37 ± 9.57	LOLA: 17/4; NM: 17/2	HBV/HCV/other; LOLA: 14/2/5; NM: 16/1/2	LOLA: 12.71 ± 3.94/7.29 ± 1.90/9, 3, 9; NM: 12.11 ± 3.11/7.05 ± 1.74/9, 4, 6	LOLA: 20/1/0; NM: 16/3/0	40/0
Casadaban et al[19], 2015	America	Retrospective cohort study/NA	91/100	n = 191; 1 month; LM (n = 24/54); LR (n = 2/5); Other (11/46); NM (n = 44/86)	54 (48, 60)	114/77	Alcoholic/HBV or HCV /alcoholic and viral/other 57/51/40/43	14 (11, 19)/9 (8, 10)/NA	94/92/5 (PVT)	160/31
Riggio et al[38], 2016	Italy	Prospective cohort study; ALB: 1 g/kg × 2 days; 0.5 g/kg day 4/day 7; 0.5 g/kg QW × 3 weeks	ALB: 0/23; NM: 9/36	n = 68; 3 weeks; ALB (n = 8/23); NM (n = 14/45)	ALB: 57.7 ± 10; NM: 55.2 ± 10.7	ALB: 17/6; NM: 28/17	Virus/alcoholic/other ALB: 9/8/6; NM: 18/18/9	ALB: 11.5 ± 3.3/NA/7, 14, 2; NM: 10.4 ± 4.2/NA/10, 25, 10	ALB: 13/10/0; NM: 21/24/0	68/0
Kovalic and Rudnick[46], 2018	America	Retrospective cohort study/NA	0/177	n = 177; 5 years; LM (14/82); NM (25/95)	LM: 54.45; NM: 56.88	NA	Alcoholic/virus/NASH; LM: 47/31/3; NM: 50/34/2	LM: 12/NA/NA; NM: 12/NA/NA	NA	NA
Subramanian et al[18], 2020	America	Retrospective cohort study/NA	LM: 12/26; RM: 3/3; LR: 46/27; NM: 5/22	n = 144; 1 year; LM (n = 16/38); RM (n = 5/6); LR (n = 47/73); NM (n = 9/27)	56.7 ± 10.2	88/56	HCV/alcoholic/other 45/87/12	15.8 ± 6/NA/NA	84/60	144/0
Seifert et al[47], 2021	Germany	Retrospective cohort study; RM: 550 mg BID × 1 year	LM: 10/75; LR: 29/30; NM: 8/75	n = 227; 1 year; LM (n = 42/85); LR (n = 16/59); NM (n = 43/83)	LM: 57 (35, 76); LR: 59 (25, 70); NM: 58 (19, 80)	LM: 52/33; LR: 30/29; NM: 56/27	Alcoholic/viral/NAFLD/other; LM: 52/9/6/18; LR: 37/1/6/15; NM: 29/10/8/36	LM: 13.3 ± 6.8/NA/22, 6, 3; LR: 19.2 ± 6.3/NA/5, 34, 19; NM: 13.2 ± 6.8/NA/35, 45, 3	LM: 18/51/16; LR: 15/30/14; NM: 43/29/11	LM: 56/29; LR: 52/7; NM: 67/16
Bureau et al[7], 2021	France	RCT; RM: 600 mg BID × 6 months	24/162	n = 197; 168 days; RM (n = 32/93); NM (n = 49/93)	RM: 61 ± 9; NM: 58 ± 8	RM: 73/24; NM: 79/21	Alcoholic/other; RM: 83/14; NM: 87/13	RM: 12 ± 4/8 ± 1/NA; NM: 12 ± 4/8 ± 1/NA	RM: 15/82; NM: 22/78	197/0

RCT: Randomized controlled study; LM: Lactulose monoprophylaxis; RM: Rifaximin monoprophylaxis; LR: Lactulose and rifaximin; NM: No prophylactic medication; LOLA: L-ornithin-l-aspartate; ALB: Albumin; NAFLD: Non-alcoholic fatty liver disease; PVT: Portal vein thrombosis; QD: Quaque die; BID: Bis in die; QW: Quaque week; NA: Not mentioned. The dosage of lactulose in the study was mainly adjusted mainly according to the patient's bowel movements to ensure 2-3 soft stools per day.