What do systematic reviews say?

Non‐absorbable disaccharides vs placebo or no intervention

Non‐absorbable disaccharides probably leads to lower mortality compared with placebo/no intervention (moderate certainty).

• Non‐absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and… 2016 · Cochrane Headline outcomes only
  RR 0.59 [0.4, 0.87]
  24 studies · 1487 participants
  Moderate

Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides vs non‐absorbable disaccharide

Summary of findings table ‐ Rifaximin plus non‐absorbable… probably leads to lower mortality ‐ total number compared with non‐absorbable disaccharides alone (moderate certainty).

• Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis 2023 · Cochrane Headline outcomes only
  RR 0.69 [0.55, 0.86]
  14 studies · 1946 participants
  Moderate

Lactulose vs lactitol

It is very uncertain whether lactulose changes mortality compared with lactitol (very low certainty).

• Non‐absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and… 2016 · Cochrane Headline outcomes only
  RR 1.3 [0.59, 2.85]
  8 studies · 225 participants
  Very low

Phamacotherapies that specifically target ammonia vs placebo or non‐absorbable disaccharides

• Pharmacotherapies that specifically target ammonia for the prevention and treatment of hepatic encephalopathy in… 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 16 participants
  Very low