Cochrane · systematic review · CD013123
Treatment for ascites in adults with decompensated liver cirrhosis: a network meta‐analysis
Benmassaoud, A, Freeman, SC, Roccarina, D, et al. · Cochrane Database of Systematic Reviews · 2020 · 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
32
current version
GRADE rated
27
No studies
5
Included studies
NR
No studies 5 · 15.6%Ungraded 0 · 0%Very low 26 · 81.3%Low 1 · 3.1%Moderate 0 · 0%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
Comparison
Population: people with liver cirrhosis and ascites
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Interventions | no estimate extracted | NR | No studies |
Paracentesis plus fluid replacement | no estimate extracted | NR | No studies |
Aldosterone antagonists plus loop diuretics (4 RCTs; 211 participants) | HR 1.05 [0.7, 1.69] | NR | Very low Downgraded: risk of bias, imprecision |
Paracentesis plus systemic vasoconstrictors (5 RCTs; 165 participants) | HR 1.64 [0.46, 6.32] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics plus paracentesis plus fluid replacement (No direct RCT) | HR 1.24 [0.62, 2.59] | NR | Very low Downgraded: risk of bias, imprecision |
Transjugular intrahepatic portosystemic shunt (7 RCTs; 452 participants) | HR 0.84 [0.6, 1.18] | NR | Very low Downgraded: risk of bias, imprecision |
No active treatment (No direct RCT) | HR 1.66 [0.46, 6.99] | NR | Very low Downgraded: risk of bias, imprecision |
Loop diuretics (No direct RCT) | HR 0.71 [0.23, 2.16] | NR | Very low Downgraded: risk of bias, imprecision |
Paracentesis plus reinfusion (1 RCT; 24 participants) | HR 0.77 [0.23, 2.68] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics plus albumin (No direct RCT) | HR 1.06 [0.57, 2.16] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics plus peritoneovenous shunt (No direct RCT) | HR 0.97 [0.4, 2.43] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics plus systemic vasoconstrictors (No direct RCT) | HR 0.42 [0.15, 1.22] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists (No direct RCT) | HR 1.92 [0.24, 20.64] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics plus systemic vasoconstrictors plus paracentesis plus fluid replacement (No direct RCT) | HR 1.11 [0.02, 39.77] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics plus systemic vasoconstrictors plus systemic vasodilator (No direct RCT) | HR 0.61 [0.02, 9.17] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics plus systemic vasodilator (No direct RCT) | HR 0.62 [0.03, 9.1] | NR | Very low Downgraded: risk of bias, imprecision |
Systemic vasoconstrictors plus albumin (No direct RCT) | HR 2.62 [0.41, 19.28] | NR | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (number of people) | no estimate extracted | NR | No studies |
Aldosterone antagonists plus loop diuretics (1 RCT; 41 participants) | Rate ratio 1.3 [0.27, 6.99] | NR | Very low Downgraded: risk of bias, imprecision |
Transjugular intrahepatic portosystemic shunt (1 RCT; 70 participants) | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Health‐related quality of life | no estimate extracted | NR | No studies |
Paracentesis plus systemic vasoconstrictors (4 RCTs; 145 participants) | OR 1.63 [0.3, 11.66] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics (2 RCT; 84 participants) | OR 3.54 [0.43, 27.41] | NR | Very low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics (1 RCT; 31 participants) | Rate ratio 4.12 [0.87, 34.02] | NR | Very low Downgraded: risk of bias, imprecision |
Paracentesis plus systemic vasoconstrictors (1 RCT; 25 participants) | Rate ratio 1.37 [0.36, 5.82] | NR | Very low Downgraded: risk of bias, imprecision |
Transjugular intrahepatic portosystemic shunt (6 RCTs; 427 participants) | HR 0.87 [0.52, 1.44] | NR | Very low Downgraded: risk of bias, imprecision |
Symptomatic resolution of ascites at maximal | no estimate extracted | NR | No studies |
Aldosterone antagonists plus loop diuretics (3 RCTs; 125 participants) | HR 1.1 [0.12, 10.74] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
Transjugular intrahepatic portosystemic shunt (6 RCTs; 392 participants) | HR 9.44 [1.93, 62.68] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
Aldosterone antagonists plus paracentesis plus fluid replacement (1 RCT; 36 participants) | HR 30.63 [5.06, 692.98] | NR | Low Downgraded: risk of bias, imprecision |
Aldosterone antagonists plus loop diuretics (4 RCTs; 242 participants) | Rate ratio 2.04 [1.37, 3.1] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
Paracentesis plus systemic vasoconstrictors (3 RCTs; 114 participants) | Rate ratio 0.76 [0.14, 3.61] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |