Trial reportCanadian journal of gastroenterology & hepatology2018
Primary Prophylaxis to Prevent the Development of Hepatic Encephalopathy in Cirrhotic Patients with Acute Variceal Bleeding.
Trial report in Canadian journal of gastroenterology & hepatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02158182 (Comparison of Three Different Schemes), which is not on this map. Cited by 18 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Three Different Schemes:Lactulose, L-ornithine L-aspartate, or Rifaximin, Versus Placebo, as Primary Prophylaxis of the Development of Hepatic Encephalopathy After Acute Variceal Bleeding in Cirrhotic Patients
Who cites it
18 citing papers in PubMed, 6 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Efficacy and safety of rifaximin for the prophylaxis of hepatic encephalopathy: A meta-analysis.Medicine · 2025Pooled it
- Efficacy and safety of rifaximin in preventing hepatic encephalopathy: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential application dosages and strategies: a network meta-analysis.BMC gastroenterology · 2024Pooled it
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Efficacy and Safety of Rifaximin in the Prevention of Recurrent Episodes of Hepatic Encephalopathy: A Systematic Review and Meta-analysis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Pooled it
- Beneficial effects of L-ornithine L-aspartate for prevention of overt hepatic encephalopathy in patients with cirrhosis: a systematic review with meta-analysis.Metabolic brain disease · 2020Pooled it
- Role of lactulose for prophylaxis against hepatic encephalopathy in cirrhotic patients with upper gastrointestinal bleeding: A randomized trial.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2021Trial
- Evaluating the Clinical Endpoint of Antibiotic Prophylaxis for Cirrhosis Patients Complicated with Upper Gastrointestinal Bleeding: An Updated Systematic Review and Meta-analysis.Acta medica Philippina · 2025Article
- D-dimer is a prognostic marker for 1-year mortality in patients with chronic liver failure and hepatic encephalopathy.Hepatology forum · 2024Article
- The Management of Hepatic Encephalopathy from Ward to Domiciliary Care: Current Evidence and Gray Areas.Journal of clinical medicine · 2023Review
- Antibiotics in Chronic Liver Disease and Their Effects on Gut Microbiota.Antibiotics (Basel, Switzerland) · 2023Review
- Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution.Journal of clinical medicine · 2023Review
- Analysis of the Dose-Response Relationship Between the International Normalized Ratio and Hepatic Encephalopathy in Patients With Liver Cirrhosis Using Restricted Cubic Spline Functions.Frontiers in public health · 2022Article
- Management of Decompensated Cirrhosis in the Surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document.Trauma surgery & acute care open · 2022Article
- Efficacy and Safety of Rifaximin Versus Placebo or Other Active Drugs in Critical ill Patients With Hepatic Encephalopathy.Frontiers in pharmacology · 2021Review
- Liver Cirrhosis and Sarcopenia from the Viewpoint of Dysbiosis.International journal of molecular sciences · 2020Review
- Encephalopathy in Cirrhosis: Prevention and Management.Journal of clinical and experimental hepatologyReview
- Primary prophylaxis of hepatic encephalopathy in decompensated cirrhosis: Low dose vs. full dose rifaximin.Pakistan journal of medical sciencesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aim: Variceal bleeding is the second most important precipitating factor related to the development of episodic hepatic encephalopathy; but to date there are no recommendations to prevent this complication. The aim of this study was to compare if primary prophylaxis with lactulose or L-ornithine L-aspartate or rifaximin, in cirrhotic patients with variceal bleeding, is better than placebo for avoiding the development of hepatic encephalopathy. Methods: A randomized, double-blind, placebo-controlled clinical trial (ClinicalTrials.gov identifier: NCT02158182) which included cirrhotic patients with variceal bleeding, without minimal or clinical hepatic encephalopathy at admission. Findings: 87 patients were randomized to one of four groups. The basal characteristics were similar between groups. Comparatively with placebo, the frequency with regard to the development of hepatic encephalopathy was as follows: lactulose (54.5% versus 27.3%; OR = 0.3, 95% CI 0.09-1.0; Conclusions: Antiammonium drugs, particularly L-ornithine L-aspartate and rifaximin, proved to be effective in preventing the development of hepatic encephalopathy in those cirrhotic patients with variceal bleeding.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.