A Randomized Controlled Trial Comparing Nitazoxanide Plus Lactulose With Lactulose Alone in Treatment of Overt Hepatic Encephalopathy.
Background and Aims: Hepatic encephalopathy (HE) is a reversible spectrum of neuropsychiatric abnormalities associated with liver dysfunction. Lactulose is a nonabsorbable disaccharide presently used to treat HE. Nitazoxanide (NTZ) has a broad-spectrum activity against urease-producing bacteria, so...
| Publicado en: | Journal of Clinical Gastroenterology Vol. 53; no. 3; pp. 226 - 231 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Mar2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=134799520&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 134799520 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01920790 4BP jtl: Journal of Clinical Gastroenterology issn: 01920790 maglogo: N pubinfo: dt: Mar2019 vid: 53 iid: 3 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 134799520 134799520 NLM29668561 134799520 10.1097/MCG.0000000000001040 NLM29668561 134799520 ppf: 226 ppct: 5 formats: tig: atl: A Randomized Controlled Trial Comparing Nitazoxanide Plus Lactulose With Lactulose Alone in Treatment of Overt Hepatic Encephalopathy. aug: au: Abd-Elsalam, Sherief El-Kalla, Ferial Elwan, Nadia Badawi, Rehab Hawash, Nehad Soliman, Shaimaa Soliman, Samah Elkhalawany, Walaa ElSawaf, Mennat-Allah Elfert, Asem affil: Tropical Medicine & Infectious Diseases, Tanta University Faculty of Medicine, Tanta sug: subj: Gastrointestinal Agents Therapeutic Use Thiazoles Therapeutic Use Liver Cirrhosis Disaccharides Therapeutic Use Human Middle Age Gastrointestinal Agents Administration and Dosage Disaccharides Administration and Dosage Male Treatment Outcomes Thiazoles Administration and Dosage Drug Administration Schedule Drug Therapy, Combination Female Hepatic Encephalopathy Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Arthritis Impact Measurement Scales Scales Middle Aged: 45-64 years Male Female ab: Background and Aims: Hepatic encephalopathy (HE) is a reversible spectrum of neuropsychiatric abnormalities associated with liver dysfunction. Lactulose is a nonabsorbable disaccharide presently used to treat HE. Nitazoxanide (NTZ) has a broad-spectrum activity against urease-producing bacteria, so it decreases ammonia production and is therefore expected to reverse the symptoms of HE. A previous pilot study on HE patients given NTZ and lactulose had encouraging results with regard to amelioration of the clinical picture. Patients showed improvement in mental status and the drug was well-tolerated. Results such as these are encouraging larger studies. The aim of this study was to compare the safety and adequacy of NTZ plus lactulose versus lactulose and placebo in management of overt HE.Methods: In total, 120 cirrhotic patients suffering from overt HE were randomly designated to take either NTZ plus lactulose (n=60) or lactulose and placebo (n=60). The Clinical Hepatic Encephalopathy Staging Scale (CHESS) score was assessed for all patients on inclusion to the study and 1 week from the start of treatment.Results: Both groups evinced an improvement in CHESS score at 1 week, yet the improvement was significantly better in the NTZ group as the score decreased from 4.15±2.09 to 0.00±0.00 compared with 4.96±2.29 to 1.28±0.91 in patients receiving lactulose and placebo (P-value <0.001).Conclusions: NTZ significantly decreases the CHESS score and improves mental status in the form of patient alertness, orientation, response to stimulation, and ability to talk. NTZ is safe and well-tolerated apart from infrequent epigastric pain. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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