Trial reportNutrients2019
Supplementation with Synbiotics and/or Branched Chain Amino Acids in Hepatic Encephalopathy: A Pilot Randomised Placebo-Controlled Clinical Study.
Trial report in Nutrients, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- The Efficacy of Gut Microbiome-Modulating Therapies on Liver Cirrhosis: A Systematic Review and Network Meta-Analysis.Clinical and translational gastroenterology · 2026Pooled it
- Branched-chain amino acids for people with cirrhosis and hepatic encephalopathy.The Cochrane database of systematic reviews · 2026Pooled it
- Probiotics are beneficial for liver cirrhosis: a systematic review and meta-analysis of randomized control trials.Frontiers in medicine · 2024Pooled it
- Pooled it
- Trial
- Amino Acid Metabolism in Health and Disease.MedComm · 2026Review
- Harnessing the power of the gut microbiome: a review of supplementation diagnosis and therapy for liver cirrhosis.Cellular and molecular life sciences : CMLS · 2026Review
- Gut Dysbiosis, Malnutrition and Sarcopenia in Liver Cirrhosis: A Narrative Review.Diseases (Basel, Switzerland) · 2026Review
- Management of hepatic encephalopathy following transjugular intrahepatic portosystemic shunts: Current strategies and future directions.World journal of gastroenterology · 2025Review
- Role of the gut microbiome in psychological symptoms associated with inflammatory bowel diseases.Seminars in immunopathology · 2025Review
- From Cirrhosis to the Dysbiosis (A Loop of Cure or Complications?).Indian journal of microbiology · 2024Review
- Microbiota-Gut-Brain Axis and Antidepressant Treatment.Current topics in behavioral neurosciences · 2024Review
- A Comprehensive Overview of the Past, Current, and Future Randomized Controlled Trials in Hepatic Encephalopathy.Medicina (Kaunas, Lithuania) · 2023Review
- Gut Microbiota and Neuroinflammation in Acute Liver Failure and Chronic Liver Disease.Metabolites · 2023Review
- Therapeutic Applications of Resveratrol in Hepatic Encephalopathy through Its Regulation of the Microbiota, Brain Edema, and Inflammation.Journal of clinical medicine · 2021Review
- Article
- Current Evidence on the Role of the Gut Microbiome in ADHD Pathophysiology and Therapeutic Implications.Nutrients · 2021Review
- The Role of the Gut Microbiome in Liver Cirrhosis Treatment.International journal of molecular sciences · 2020Review
- Gut-Brain Axis: Role of Gut Microbiota on Neurological Disorders and How Probiotics/Prebiotics Beneficially Modulate Microbial and Immune Pathways to Improve Brain Functions.International journal of molecular sciences · 2020Review
- From intestinal dysbiosis to alcohol-associated liver disease.Clinical and molecular hepatology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHepatic encephalopathy (HE) is common in patients with cirrhosis and is characterised by reduced hepatic ammonia clearance. This is accompanied by alterations in gut bacteria that may be ameliorated with synbiotics (pro- and prebiotics). Branched chain amino acids (BCAAs) are thought to have a role in the detoxification of ammonia. We investigated the effects of the administration of synbiotics and/or BCAAs in treating HE.
methodsParticipants with overt HE were randomised in a blinded placebo-controlled study to receive synbiotics, BCAAs, or a combination of BCAAs and Synbiotics. Relevant biochemical and nutritional data and depression and anxiety scores (DASS-21) were collected at entry, 4 weeks, and on completion, at 8 weeks. The Trail Making Test (TMT) and Inhibitory Control Test (ICT) were used to assess cognitive function in patients withHE. Results were analysed using linear mixed effects regression analyses.
resultsSixty-one participants were enrolled and 49 who returned for at least 1 follow-up review were included in the intention to treat analysis. The mean age was 55.8 ± 6.1 years and 86% were males. Despite evidence of a placebo effect, there was significant improvement in TMT B and ICT weighted lures in participants who received combined synbiotics/BCAAs treatment compared to placebo at study completion (
conclusionTo our knowledge, this is the first study reporting that combined synbiotics and BCAAs improve HE, and that may be beneficial in the management of HE. A larger study is needed to confirm these results.
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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.