Ventura-Cots, MeritxellSimón Talero, MacarenaPoca Pastor, María AntoniaAriza Piquer, XavierMasnou, HelenaSanchez, JordiLlop, ElbaCañete, NúriaMartín Llahí, MartaAmador Navarrete, AlbertoMartínez, JavierClemente-Sánchez, AnaPuente, AngelaTorrens, MariaAlvarado-Tapias, EdilmarNapoleone, LauraMiquel-Planas, MireiaArdèvol, AlbaCasas Rodrigo, MeritxellCalleja Panero, José LuisSolé Padullés, CristinaSoriano Pastor, GermánGenescà, Joan2021-11-252021-11-252021-10-23https://hdl.handle.net/2445/181450No 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.application/pdfengcc-by (c) Ventura-Cots, Meritxell et al., 2021http://creativecommons.org/licenses/by/3.0/es/AlbúminesAssaigs clínicsEncefalopatia hepàticaAlbuminsClinical trialsHepatic encephalopathyinfo:eu-repo/semantics/article2021-11-25info:eu-repo/semantics/openAccess34768404