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jcm-10-04885-v3.pdf (1.09 MB)

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2021-10-23

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cc-by (c) Ventura-Cots, Meritxell et al., 2021
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/181450

Effects of Albumin on Survival after a Hepatic Encephalopathy Episode: Randomized Double-Blind Trial and Meta-Analysis

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https://doi.org/10.3390/jcm10214885

Resum

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.

Matèries

Albúmines, Assaigs clínics, Encefalopatia hepàtica

Matèries (anglès)

Albumins, Clinical trials, Hepatic encephalopathy

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Articles publicats en revistes (Infermeria Fonamental i Clínica)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

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. Effects of Albumin on Survival after a Hepatic Encephalopathy Episode: Randomized Double-Blind Trial and Meta-Analysis. _Journal of Clinical Medicine_. 2021. Vol. 10, núm. 21, pàgs. 4885. [consulta: 23 de gener de 2026]. [Disponible a: https://hdl.handle.net/2445/181450]

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