Trial reportHepatology international2020
Utility of N-acetylcysteine in ischemic hepatitis in cirrhotics with acute variceal bleed: a randomized controlled trial.
Trial report in Hepatology international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02015403 (TO COMPARE THE EFFICACY OF N -ACETYLCYSTEINE AND STANDARD THERAPY VERSUS STANDARD THERAPY IN THE PREVENTION OF ISCHEMIC HEPATITIS AND SURVIVAL POST UPPER GI BLEED), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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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.
To compare the efficacy of n -acetylcysteine and standard therapy versus standard therapy in the prevention of ischemic hepatitis and survival post upper gi bleed
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- One in four patients with gastrointestinal bleeding develops shock or hemodynamic instability: A systematic review and meta-analysis.World journal of gastroenterology · 2023Pooled it
- Heart-Liver Interactions: Pathophysiology and Diagnosis of Hypoxic Hepatitis, Congestive Hepatopathy, and Cirrhotic Cardiomyopathy.Diagnostics (Basel, Switzerland) · 2026Review
- Multiple Organ Failure as a Strong Predictor of Mortality in Patients with Hypoxic Hepatitis.Journal of clinical medicine · 2025Article
- Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.Hepatology international · 2025Review
- N-acetylcysteine in Kidney Disease: Molecular Mechanisms, Pharmacokinetics, and Clinical Effectiveness.Kidney international reports · 2024Review
- Emergent rescue transjugular intrahepatic portosystemic shunt within 8 h improves survival in patients with refractory variceal bleed.Hepatology international · 2023Article
- Antioxidant therapy on ischemic hepatitis: here we are and where do we go?Hepatology international · 2020Article
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 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsIschemic hepatitis (IH) following acute variceal bleed (AVB) carries an ominous prognosis. N-Acetylcysteine (NAC), a potent anti-oxidant, may prevent IH by improving tissue oxygen delivery and improving hepatic hypoxia.
methodsConsecutive cirrhotics with AVB were prospectively randomized to receive either standard of care (SOC) plus NAC intravenously for 72 h(at 150 mg/kg/h for 1 h followed by 12.5 mg/kg/h for 4 h, followed by 6.25 mg/kg for 67 h) (Group A, n = 107) or SOC alone (Group B, n = 107).
resultsBaseline characteristics were comparable. IH developed more frequently in Gr.B 25(23%) than A-15(14%); p = 0.08). Incidence of IH increased with severity of liver disease. Binary logistic regression analysis showed reduced incidence of IH in Gr.A than B [odds ratio (OR) 0.33, 0.11-0.93] patients after controlling for other significant factors. The incidence of acute kidney injury (AKI) was also reduced in Gr.A [OR 0.34, 0.15-0.75]. Development of IH was significantly associated with increased deaths due to liver failure at 6 weeks [subdistribution hazard ratio (SHR) 21.6, 7.4-62.8]. On multivariate competing risk analysis, significantly lower deaths due to liver failure (SHR 0.33, 0.11-0.97) were noted in Gr.A than B.
conclusionsOne in five patients with acute variceal bleed develops ischemic hepatitis which is associated with worse outcomes. NAC therapy averts deaths due to liver failure by preventing IH and reduces AKI and is, therefore, recommended for cirrhotics with acute variceal bleed.
trial registrationClinicaltrials.gov no: NCT02015403.
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