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Naloxone in the management of hepatic encephalopathy
1Department of Pharmacy, The Second People's Hospital of Sichuan Province & Sichuan Provincial Cancer Hospital, Chengdu, China.
Background/Aim:
This study aimed to assess the effectiveness and safety of naloxone in the management of hepatic encephalopathy (HE).
Methods:
Cochrane collaboration methodology was used in a meta-analysis of randomized controlled trials of naloxone therapy for HE.
Results:
Seventeen randomized trials were identified with 15 studies involving 1054 patients meeting criteria for inclusion. Naloxone use was associated with a significant improvement in HE [relative risk (RR) 1.46; 95% confidence interval (CI) 1.27-1.67; P = 0.0005]. This comparison showed statistical heterogeneity (P < 0.10, and χ2 = 44.93). Subgroup analysis indicated naloxone administered parenterally by intermittent or continuous infusions to be effective (RR 1.34; 95% CI 1.17-1.53; P < 0.0001). A significant in trials by infusion route (RR 1.42; 95% CI 1.19-1.69; P < 0.0001) interaction was observed.
Conclusions:
Naloxone may improve HE. However, published data are limited.
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