title: Antifibrinolytic amino acids for upper gastrointestinal bleeding in people 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. People with liver disease frequently have haemostatic abnormalities such as 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 people with liver diseases. This is an update of this Cochrane review.
  
  
  OBJECTIVE
  To assess the beneficial and harmful effects of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease.
  
  
  METHODS
  We searched The Cochrane Hepato-Biliary Controlled Trials Register (February 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2 of 12, 2015), MEDLINE (Ovid SP) (1946 to February 2015), EMBASE (Ovid SP) (1974 to February 2015), Science Citation Index EXPANDED (1900 to February 2015), LILACS (1982 to February 2015), World Health Organization Clinical Trials Search Portal (accessed 26 February 2015), and the metaRegister of Controlled Trials (accessed 26 February 2015). 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
  We planned to summarise data from randomised clinical trials using standard Cochrane methodologies and assessed according to the GRADE approach.
  
  
  RESULTS
  We found no randomised clinical trials assessing antifibrinolytic amino acids for treating upper gastrointestinal bleeding in people with acute or chronic liver disease. We did not identify quasi-randomised, historically controlled, or observational studies in which we could assess harms.
  
  
  CONCLUSIONS
  This updated Cochrane review identified no randomised clinical trials assessing the benefits and harms of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease. 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 or refute antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver diseases.
authors.affiliation: Iberoamerican Cochrane Network, Valencia, Venezuela.
authors.forename: Arturo J
authors.initials: AJ
authors.lastname: Martí-Carvajal
authors.forename: Ivan
authors.initials: I
authors.lastname: Solà
mesh_terms: D000208:Acute Disease; D000596:Amino Acids / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D008107:Liver Diseases / Q000150:complications*
chemical_list: D000596:Amino Acids; D000933:Antifibrinolytic Agents