Cochrane · systematic review · CD011585
Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis
Zacharias, HD, Kamel, F, Tan, J, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Hepato-BiliaryAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
20
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 9 · 45%Low 5 · 25%Moderate 6 · 30%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings table ‐ Rifaximin compared to placebo/no intervention for prevention and treatment of hepatic encephalopathy in people with cirrhosis
Population: prevention and treatment of hepatic encephalopathy in people with cirrhosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality ‐ total number Summary of findings table ‐ Rifaximin vs placebo/no intervention | RR 0.83 [0.5, 1.38] | 13 studies · 1007 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Serious adverse events ‐ total number of participants Summary of findings table ‐ Rifaximin vs placebo/no intervention | RR 1.05 [0.83, 1.32] | 9 studies · 801 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Health‐related quality of life ‐ assessed using: SIP score (3 trials) or EQ‐5D‐3L score (1 trial) Summary of findings table ‐ Rifaximin vs placebo/no intervention | no estimate extracted | 4 studies · 214 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Hepatic encephalopathy ‐ total number Summary of findings table ‐ Rifaximin vs placebo/no intervention | RR 0.56 [0.42, 0.77] | 13 studies · 1009 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Non‐serious adverse events ‐ total number of particiapnts Summary of findings table ‐ Rifaximin vs placebo/no intervention | RR 2.79 [0.44, 17.78] | 6 studies · 639 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Blood ammoniameasured in μmol/L, μg/dL or mmol/L at trial end Summary of findings table ‐ Rifaximin vs placebo/no intervention | no estimate extracted | 6 studies · 381 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Number Connection Test Aassessed using: Z‐score (1 trial) or seconds (3 trials) assessed at trial end Summary of findings table ‐ Rifaximin vs placebo/no intervention | no estimate extracted | 4 studies · 203 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Summary of findings table ‐ Rifaximin compared to non‐absorbable disaccharide for prevention and treatment of hepatic encephalopathy in people with cirrhosis
Population: prevention and treatment of hepatic encephalopathy in people with cirrhosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality ‐ total number Summary of findings table ‐ Rifaximin vs non‐absorbable disaccharide | RR 0.99 [0.49, 1.97] | 10 studies · 786 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Serious adverse events ‐ total number of participants Summary of findings table ‐ Rifaximin vs non‐absorbable disaccharide | RR 0.97 [0.66, 1.4] | 8 studies · 681 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Health‐related quality of life assessed using: SF‐8 (1 trial) or SIP score (1 trial) at trial end Summary of findings table ‐ Rifaximin vs non‐absorbable disaccharide | no estimate extracted | 2 studies · 249 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Hepatic encephalopathy ‐ total number Summary of findings table ‐ Rifaximin vs non‐absorbable disaccharide | RR 0.85 [0.69, 1.05] | 13 studies · 921 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Non‐serious adverse events ‐ total number of participants Summary of findings table ‐ Rifaximin vs non‐absorbable disaccharide | RR 0.57 [0.15, 2.13] | 6 studies · 396 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Blood ammoniameasured in mmol/L, μg/dL, μmol/L, μg/100mL, or μg/mL at trial end Summary of findings table ‐ Rifaximin vs non‐absorbable disaccharide | no estimate extracted | 10 studies · 599 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Number Connection Test Aassessed using: grade (1 trial), seconds (4 trials), or Z‐score (2 trials) at trial end Summary of findings table ‐ Rifaximin vs non‐absorbable disaccharide | no estimate extracted | 7 studies · 507 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides compared to non‐absorbable disaccharides alone for prevention and treatment of hepatic encephalopathy in people with cirrhosis
Population: prevention and treatment of hepatic encephalopathy in people with cirrhosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality ‐ total number Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides vs non‐absorbable disaccharides alone | RR 0.69 [0.55, 0.86] | 14 studies · 1946 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Serious adverse events ‐ total number of participants Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides vs non‐absorbable disaccharides alone | RR 0.66 [0.45, 0.98] | 7 studies · 1076 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Hepatic encephalopathy ‐ total number Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides vs non‐absorbable disaccharides alone | RR 0.58 [0.48, 0.71] | 17 studies · 2332 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Non‐serious adverse events ‐ total number of participants Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides vs non‐absorbable disaccharides alone | RR 0.99 [0.86, 1.15] | 4 studies · 384 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Blood ammonia measured in μg/mL at trial end Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides vs non‐absorbable disaccharides alone | no estimate extracted | 2 studies · 325 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Number Connection Test A, assessed using: seconds (1 trial) or Z‐score (1 trial) at trial end Summary of findings table ‐ Rifaximin plus non‐absorbable disaccharides vs non‐absorbable disaccharides alone | no estimate extracted | 2 studies · 76 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |