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A meta-analysis of microbiome therapies for hepatic encephalopathy.

Abstract
Microbiome therapies may be reported to be effective in hepatic encephalopathy (HE). We thus did a meta-analysis of randomized controlled trials to assess the effect of microbiome therapies for HE. We systematically searched PubMed, Web of Science, EMBASE, and Cochrane Library for randomized controlled trials that compared the different treatments for HE including probiotics, symbiotics, and fecal microbiota transplant (FMT). Meta-analysis was performed to calculate pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Twenty-one studies met our inclusion criteria (N = 1746 participants). Probiotics, synbiotics and FMT significantly reversed minimal HE (MHE) (OR: 0.41, 95% CI: 0.19-0.90, P = 0.03), reduced overt HE (OHE) development (OR, 0.41; 95% CI: 0.28-0.61 P < 0.00001)and the frequency of serious adverse events(SAEs) (OR:0.14, 95% CI: 0.04-0.47, P = 0.001), meanwhile decreased ammonia levels (WMD: -9.26, 95% CI: -16.92 to -1.61; P = 0.02), NCT level (MD = -4.41, 95% CI: -0.87 to -0.22, P = 0.04) and hospitalization rates (OR, 0.38; 95% CI: 0.19-0.79, P = 0.009) compared with placebo/no treatment. Finally, we conclude that microbiome therapies were more effective in improving MHE and preventing progression to OHE, reducing the frequency of SAEs, and decreasing ammonia levels, NCT level, and hospitalization rates when compared to placebo/no treatment.
AuthorsJie Gao, Rui Nie, Hong Chang, Wei Yang, Qian Ren
JournalEuropean journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 35 Issue 9 Pg. 927-937 (09 01 2023) ISSN: 1473-5687 [Electronic] England
PMID37505972 (Publication Type: Journal Article, Meta-Analysis)
CopyrightCopyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Chemical References
  • Ammonia
Topics
  • Humans
  • Ammonia
  • Hepatic Encephalopathy (prevention & control)
  • Microbiota
  • Probiotics (adverse effects)
  • Synbiotics
  • Randomized Controlled Trials as Topic

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