Effects of albumin on survival after a hepatic encephalopathy episode: randomized double-blind trial and meta-analysis
Mostra el registre complet Registre parcial de l'ítem
- dc.contributor.author Ventura-Cots, Meritxell
- dc.contributor.author Cañete Hidalgo, Nuria
- dc.contributor.author Genescà, Joan
- dc.date.accessioned 2022-09-08T06:31:59Z
- dc.date.available 2022-09-08T06:31:59Z
- dc.date.issued 2021
- dc.description.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.
- dc.format.mimetype application/pdf
- dc.identifier.citation Ventura-Cots M, Simón-Talero M, Poca M, Ariza X, Masnou H, Sanchez J, et al. Effects of albumin on survival after a hepatic encephalopathy episode: randomized double-blind trial and meta-analysis. J Clin Med. 2021 Oct 23; 10(21): 4885. DOI: 10.3390/jcm10214885
- dc.identifier.doi http://dx.doi.org/10.3390/jcm10214885
- dc.identifier.issn 2077-0383
- dc.identifier.uri http://hdl.handle.net/10230/54022
- dc.language.iso eng
- dc.publisher MDPI
- dc.rights Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Albumin
- dc.subject.keyword Clinical trial
- dc.subject.keyword Hepatic encephalopathy
- dc.subject.keyword Meta-analysis
- dc.title Effects of albumin on survival after a hepatic encephalopathy episode: randomized double-blind trial and meta-analysis
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion