Minireviews
Copyright ©The Author(s) 2021.
World J Gastroenterol. Jun 14, 2021; 27(22): 3050-3063
Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.3050
Table 5 Published studies using antibiotics for minimal hepatic encephalopathy treatment
Ref.
Study type
Follow-up (wk)
MHE diagnosis
Active treatment (s)
Objectives
Patients (n)
Main results/impact measures
No history of OHE1
Ahluwalia et al[66], 2014Quasi-experimental8 NCT-A, NCT-B, DST, BDS, LTT, SDT, ICTRifaximin4fMRI, ICT, MRS520Changes in ICT, improvement of 12% respect to baseline, indicating a better cognition
Bajaj et al[61], 2013Quasi-experimental8 NCT-A, NCT-B, DST, BDT, LTTRifaximin4Psychometry520Improvement in NCT-A time (11.8%), NCT-B time (11.8%), DST raw score (9.1%), BDT raw score (0.0%), LTT time (20.7%), LTT errors (39.8%), SDT time (12.3%) from basal values
Bajaj et al[67], 2011Randomized, single-blinded8 NCT-A, DST, BDT, ICTRifaximin/placebo4Driving performance, psychometry scores21/21Decrease of 46.6% of total errors respect to baseline in rifaximin group (P < 0.001)6. Improvement in NCT-A 91% vs 61% (NNT: 4); NCT-B: 81% vs 33% (NNT: 2); and ICT lures: 76% vs 43% (NNT: 3)7
Sidhu et al[59], 2015Randomized, non-inferiority trial12NCT-A, FCT-A, DST, PCT, and BDTRifaximin/lactuloseReversal of MHE57/55ITT analysis shows a reversal at 2 wk: lactulose 40.0% vs rifaximin 52.63% (NNT: 8). ITT analysis at 3 mo shows reversal in 69.1% and 73.7% of lactulose and rifaximin, (NNT: 22)
Goyal et al[62], 2017Prospective cohort24NCT-A, FCT-A, DST, PCT, BDTPrevious intake of Rifaximin compared to lactulose3,4Maintenance of remission for MHE42/38Still free of MHE: Rifaximin 42.8% vs lactulose 50.0% (NNT: 14)
Possible history of OHE1
Agrawal et al[24], 2011Quasi-experimental1 NCT, FTC, LTT.Clarithromycin, lansoprazole, tinidazole3,4Psychometric scores535Improvement in 12.7%, 13.3%, and 18.7% respect to basal mean time in NCT, FCT and LTT, respectively
Zhang et al[27], 2015Quasi-experimental 5NCT-A, NCT-B, DSTRifaximin 1 wk3,4Reversal of MHE26After a week, reversal present in 11/26 (42.3%)
Sidhu et al[56], 2011Double-blind, randomized 8 NCT-A/FCT-A, DST, PCT, BDTRifaximin/placeboReversal of MHE49/45Reversal at 2 wk: 57% vs 18% (NNT: 3)At 8 wk: Reversal of 75.5% vs 20% (NNT: 2)
Sharma et al[40], 2014Randomized2 8 NCT-A/FCT-A, DST and/ or CFFLOLA/rifaximin/Probiotics/Placebo4Reversal of MHE531/31/32/30 ITT analysis: Improvement in CFF values (Hz) from baseline in 11.42%, 6.5%, 8.68%, and 2.28%