Hepatic encephalopathy therapy: An overview

Table 1 RCTs on the prevention of episodes of overt hepatic encephalopathy

Ref.	Type and NO. of patients included	Aim of the study	Tested treatment (s)	Control treatment	Results
Riggio et al[38] 2005	Patients submitted to TIPS (75)	Prevention of post TIPS HE	Lactitol (60 g/d) rifaximin (1200 mg/d)	No treatment (25)	No difference between treatment and control groups
Sharma et al[39] 2009	Patients who recovered from HE (140)	Prevention of recurrence of HE (secondary prophylaxis)	Lactulose (30-60 mL in 2 or 3 divided doses)	No treatment (70)	Lactulose effective
Kanematsu et al[42] 1988	Patients submitted to surgery (56)	Prevention of HE precipitated by surgery	BCAA enriched solution, (29)	Conventional AA solution (27)	No difference between treatment and control groups
Rolachon et al[24] 1994	Patients bleeding from varices	Prevention of HE precipitated by bleeding	Gut cleansing using mannitol by naso-gastric tube	No treatment	Gut cleansing effective
Bass et al[53] 2009	History of HE	Prevention of recurrence of HE (secondary prophylaxis)	Rifaximin 550 mg twice daily for 6 mo	Placebo	Rifaximin effective

TIPS: Transjugular intrahepatic portosystemic shunt; HE: Hepatic encephalopathy; BCAA: Branched-chain amino acid.