Table 2.
Randomised trials on non-absorbable disaccharides versus antibiotics in treatment of patients with hepatic encephalopathy
|
No of patients randomised
|
Type of hepatic encephalopathy
|
Experimental/control intervention
|
No of patients without improvement/total†
|
No of dropouts/total
|
|||||
|---|---|---|---|---|---|---|---|---|---|
| Study design | Quality* | Experimental | Antibiotics | Experimental | Antibiotics | ||||
| Conn 19775
|
Crossover
|
High
|
33
|
Chronic
|
Lactulose + placebo/neomycin + sorbitol
|
3/18
|
2/15
|
None in 1st period
|
|
| Atterbury 19786 | Parallel | High | 47 | Acute | Lactulose + placebo/neomycin + sorbitol | 4/23 | 4/24 | 1/23 | 1/24 |
| Orlandi 198130 | Parallel | High | 190 | Acute + chronic | Lactulose/neomycin + magnesium sulfate | 63/91 | 48/82 | 17§ | |
| Russo 198931
|
Crossover
|
Low
|
15
|
Chronic
|
Lactulose/ribostamycin
|
1/8
|
2/7
|
Unknown
|
|
| Blanc 199332 | Parallel | Low | 60 | Acute | Lactitol/vancomycin | 9/29 | 10/31 | 2/29 | 2/31 |
| Bucci 199333
|
Parallel
|
Low
|
58
|
Unknown
|
Lactulose + placebo/rifaximin + sorbitol
|
‡
|
Unknown
|
||
| Fera 199334
|
Parallel
|
Low
|
40
|
Unknown
|
Lactulose + placebo/rifaximin + placebo
|
4/20
|
0/20
|
Unknown
|
|
| Festi 199335
|
Parallel
|
Low
|
21
|
Chronic
|
Lactulose/rifaximin
|
‡
|
Unknown
|
||
| Massa 199336
|
Parallel
|
High
|
40
|
Chronic
|
Lactulose + placebo/rifaximin + sorbitol
|
2/20
|
0/20
|
Unknown
|
|
| Song 200037 | Parallel | Low | 64 | Unknown | Lactulose/rifaximin | 7/25 | 8/39 | 1/25 | 1/39 |
| Loguercio 200338 | Parallel | Low | 27 | Chronic | Lactitol + placebo/rifaximin + placebo | 11/13 | 6/14 | 3/13 | 2/14 |
| Mas 200339 | Parallel | High | 103 | Acute | Lactitol + placebo/rifaximin + placebo | 12/53 | 10/50 | 7/53 | 8/50 |
*
Classified with adequate allocation concealment and adequate blinding as high quality.
†
Improvement defined as partial or complete resolution of clinical or subclinical symptoms of hepatic encephalopathy.
‡
Experimental and control intervention reported to be equally effective but numerical data not available.
§
Exact number of dropouts in each intervention group not reported and accordingly it was not possible to perform intention to treat analysis for this trial.