Gut microbiota and liver diseases

Table 4 Randomized controlled trials for hepatic encephalopathy

Ref.	Year	Sample size(treatment/placebo)	Treatment regimens	Duration	Favorable effects
12Loguercio et al[69]	1987	40 (20/20)	Enterococcus Lactic Acid bacteria strain SF68 vs lactulose	10 d	NH3↓
					Performance status: improved
2Loguercio et al[70]	1995	40 (21/19)	Enterococcus Lactic Acid bacteria strain SF68 vs lactulose	3 x 4 wk	NH3↓
					Psychometric test: improved
12Liu et al[71]	2004	55 (20/35)	Pediacoccus pentoseceus, Leuconostoc mesenteroides, Lactobacillus paracasei, and Lactobacillus plantarum with fermentable fibers vs fermentable fibers only or non-fermentable fiber	30 d	Endotoxemia ↓Child-Turcotte-Pugh classification: improved
2Malaguarnera et al[72]	2007	60 (30/30)	Bifidobacterium (subtype not available) with fructo-oligosaccharide (FOS) vs mix of vitamins	90 d	NH3↓
					Psychometric test: improved
12Bajaj et al[73]	2008	25 (17/8)	Streptococcus thermophilus, Lactobacillus bulgaricus, Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacteria vs none	60 d	Psychometric test: improved
12Sharma et al[74]	2008	105 (70/35)	Streptococcus faecalis, Clostridium butyricum, Bacillus mesentricus, and Lactic acid bacillus with lactulose vs lactulose	30 d	NH3↓
					Psychometric test: improved
12Mittal et al[75]	2011 (2009)	160 (120/40)	VSL#3 (containing Streptococcus thermophilus, Bifidobacterium breve, Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus paracasei, Lactobacillus bulgaricus) vs lactulose or placebo	3 mo	NH3 (arterial) ↓
1Malaguarnera et al[76]	2010	125 (63/62)	Bifidobacterium (subtype not available) and FOS vs lactulose	60 d	NH3↓
					Psychometric test: improved
1Pereg et al[77]	2011	40 (20/20)	Lactobacillus acidophilus, Lactobacillus bulgaricus, Bifidobacterium bifidum, and Streptococcus thermophiles (Bio-plus, Supherb, Israel) vs placebo	6 mo	NH3↓
Agrawal et al[80]	2012	235 (157/78)	VSL#3 vs lactulose or none	> 3 mo	NH3 (arterial) ↓
					Psychometric test: improved
					Secondary prophylaxis of HE
Lunia et al[81]	2014	160 (86/74)	VSL#3 vs placebo	> 6 mo	NH3 (arterial) ↓
					Prevention of HE

¹RCTs included in meta-analysis by McGee et al[78];

²RCTs included in meta-analysis by Holte et al[79].