title: Antifibrinolytic amino acids for upper gastrointestinal bleeding in patients with acute or chronic liver disease.
abstract: BACKGROUND
  Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. Patients with liver disease frequently have haemostatic abnormalities like hyperfibrinolysis. Therefore, antifibrinolytic amino acids have been proposed to be used as supplementary interventions alongside any of the primary treatments for upper gastrointestinal bleeding in patients with liver diseases.
  
  
  OBJECTIVE
  To assess the beneficial and harmful effects of antifibrinolytic amino acids for upper gastrointestinal bleeding in patients with acute or chronic liver disease.
  
  
  METHODS
  We searched the Cochrane Hepato-Biliary Group Controlled Trials Register (11 June 2012), Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2012, Issue 5 of 12), MEDLINE (Ovid SP) (1946 to June 2012), EMBASE (Ovid SP) (1974 to June 2012), Science Citation Index EXPANDED (1900 to June 2012), LILACS (1982 to June 2012), Clinical Trials Search Portal of the WHO (accessed June 18, 2012), and the Metaregister of Controlled Trials (accessed June 18, 2012). We scrutinised the reference lists of the retrieved publications.
  
  
  METHODS
  Randomised clinical trials irrespective of blinding, language, or publication status for assessment of benefits and harms. Observational studies for assessment of harms.
  
  
  METHODS
  Data from randomised clinical trials were to be summarised by standard Cochrane Collaboration methodologies.
  
  
  RESULTS
  We could not find any randomised clinical trials assessing antifibrinolytic amino acids for treating upper gastrointestinal bleeding in patients with acute or chronic liver disease. We could not identify quasi-randomised, historically controlled, or observational studies in which we could assess harms.
  
  
  CONCLUSIONS
  No randomised clinical trials assessing the benefits and harms of antifibrinolytic amino acids for upper gastrointestinal bleeding in patients with acute or chronic liver disease were identified. The benefits and harms of antifibrinolytic amino acids need to be tested in randomised clinical trials. Unless randomised clinical trials are conducted to assess the trade off between benefits and harms, we cannot recommend nor refute antifibrinolytic amino acids for upper gastrointestinal bleeding in patients with acute or chronic liver diseases.
authors.affiliation: Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador. arturo.marti.carvajal@gmail.com.
authors.forename: Arturo J
authors.initials: AJ
authors.lastname: Martí-Carvajal
authors.forename: Ivan
authors.initials: I
authors.lastname: Solà
authors.forename: Pedro I
authors.initials: PI
authors.lastname: Martí-Carvajal
mesh_terms: D000596:Amino Acids / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008107:Liver Diseases / Q000150:complications*
chemical_list: D000596:Amino Acids; D000933:Antifibrinolytic Agents