Naloxone in the management of hepatic encephalopathy.
OBJECTIVE
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.
Jiang
Q
Q
Department of Pharmacy, The Second People's Hospital of Sichuan Province & Sichuan Provincial Cancer Hospital, Chengdu, China.
Jiang
G
G
Welty
T E
TE
Zheng
M
M
D006501:Hepatic Encephalopathy / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D009270:Naloxone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D009292:Narcotic Antagonists; D009270:Naloxone