Hepatic encephalopathy therapy: An overview

Table 4 Some of the RCTs available on the treatment of hepatic encephalopathy

Ref.	Type of study	Type of HE/patients (n)	Tested treatment	Control treatment	Results
Uribe et al[23] 1987	Double-blind, controlled trial	Episodic overt HE (20)	Lactitol and lactose enemas	Nonacidifying enemas	Acidifying agents like lactose and lactitol are effective and superior to tap-water enemas for the treatment of HE
Hassanein et al[31] 2007	Prospective, randomized, controlled, multicenter trial	Severe episodic overt HE (70)	Molecular adsorbent recirculating system (MARS) and standard medical therapy	Standard medical therapy	MARS is associated with an earlier and more frequent improvement of HE
Kircheis et al[57] 1997	Randomized, double-blind, placebo-controlled, multicenter trial	MHE (53) and mild overt HE (grade I-II, 53)	L-ornithine-L-aspartate, 20 g/d i.v.	Placebo	Therapy improves psychometric performance and is safe and effective in HE treatment
Stauch et al[58] 1998	Randomized, double-blind, placebo-controlled clinical trial	MHE (23) and mild overt HE (43)	L-ornithine-L-aspartate, 9 g/d orally	Placebo	Therapy improves psychometric performance, blood ammonia levels and is safe and effective in HE treatment
Ahmad et al[59] 2008	RCT	Overt HE (80)	L-ornithine-L-aspartate, 20 g/d i.v.	Placebo	Treatment improves blood ammonia and mental state
Sushma et al[62] 1992	Prospective randomized double-blind study	Overt HE (74)	Sodium Benzoate, 5 g	Lactulose	Improvement in portal-systemic encephalopathy parameters occurred in both treatment groups and was similar
Reding et al[66] 1984	Double-blind randomised trial	Chronic HE (22)	Zinc acetate 600 mg/d	Placebo	Treatment improves psychometric performance
Riggio et al[67] 1991	Double-blind, crossover trial	Chronic HE (15)	Zinc sulfate 600 mg/d and lactitol	Lactitol	Zinc was significantly raised after oral administration, but no modification in the parameters included in Conn's index were observed
Loguercio et al[72] 1995	Double blind parallel trial	HE (40)	SF-68	Lactulose	SF-68 improves blood ammonia and psychometric performance
Gentile[75] 2005	Randomized, double-blind, crossover study	HE (107)	Acarbose 300 mg/d	Placebo	Acarbose improves blood ammonia levels and HE clinical parameters