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Title: | Effects of Albumin on Survival after a Hepatic Encephalopathy Episode: Randomized Double-Blind Trial and Meta-Analysis |
Author: | Ventura-Cots, Meritxell Simón Talero, Macarena Poca Pastor, María Antonia Ariza Piquer, Xavier Masnou, Helena Sanchez, Jordi Llop, Elba Cañete, Núria Martín Llahí, Marta Amador Navarrete, Alberto Martínez, Javier Clemente-Sánchez, Ana Puente, Angela Torrens, Maria Alvarado-Tapias, Edilmar Napoleone, Laura Miquel-Planas, Mireia Ardèvol, Alba Casas Rodrigo, Meritxell Calleja Panero, José Luis Solé Padullés, Cristina Soriano Pastor, Germán Genescà, Joan |
Keywords: | Albúmines Assaigs clínics Encefalopatia hepàtica Albumins Clinical trials Hepatic encephalopathy |
Issue Date: | 23-Oct-2021 |
Publisher: | MDPI |
Abstract: | No therapies have been proven to increase survival after a hepatic encephalopathy (HE) episode. We hypothesize that two doses of albumin could improve 90-day survival rates after a HE episode. Methods: (1) A randomized double-blind, placebo-controlled trial (BETA) was conducted in 12 hospitals. The effect of albumin (1.5 g/kg at baseline and 1 g/kg on day 3) on 90-day survival rates after a HE episode grade II or higher was evaluated. (2) A meta-analysis of individual patient's data for survival including two clinical trials (BETA and ALFAE) was performed. Results: In total, 82 patients were included. Albumin failed to increase the 90-day transplant-free survival (91.9% vs. 80.5%, p = 0.3). A competing risk analysis was performed, observing a 90-day cumulative incidence of death of 9% in the albumin group vs. 20% in the placebo (p = 0.1). The meta-analysis showed a benefit in the albumin group, with a lower rate of clinical events (death or liver transplant) than patients in the placebo (HR, 0.44; 95% CI, 0.21-0.82), when analyzed by a competing risk analysis (90-days mortality rate of 11% in the albumin group vs. 30% in the placebo, p = 0.02). Conclusions: Repeated doses of albumin might be beneficial for patient's survival as an add-on therapy after an HE episode, but an adequately powered trial is needed. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/jcm10214885 |
It is part of: | Journal of Clinical Medicine, 2021, vol. 10, issue. 21, p. 4885 |
URI: | http://hdl.handle.net/2445/181450 |
Related resource: | https://doi.org/10.3390/jcm10214885 |
Appears in Collections: | Articles publicats en revistes (Infermeria Fonamental i Clínica) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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File | Description | Size | Format | |
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jcm-10-04885-v3.pdf | 1.12 MB | Adobe PDF | View/Open |
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