Systematic review with network meta-analysis: the comparative effectiveness and safety of interventions in XXXX with overt @entity99 .

@entity1 @entity7967 @entity1522 @entity3265 @entity1761 @entity5154 @entity35861 @entity99
BACKGROUND: Interventional treatment for overt @entity99 (OHE), includes non-absorbable @entity7967 , @entity5154 , @entity1761 , @entity35861 and branched chain @entity1522 (BCAA). However, the optimum regimen remains inconclusive. AIM: To compare interventions in terms of @entity1 ' adverse events and major clinical outcomes. METHODS: Literature search of PubMed, Embase, Scopus, and Cochrane Library studies published up to July 31 2014. RCTs of above interventions in OHE @entity1 were included. Network meta-analysis combined direct and indirect evidence to estimate odds ratios (ORs) and mean difference (MD) between treatments and the probabilities of ranking for treatment based on clinical outcomes. RESULTS: Twenty eligible RCTs were included. When compared with observation, only @entity35861 (OR 3.71, P  <  0.001) and BCAA (OR 3.37, P  <  0.001) improved clinical efficacy significantly. However, when @entity35861 was compared with BCAA, non-absorbable @entity7967 and @entity5154 , there was a trend suggesting that @entity35861 may be the most effective intervention with respect to clinical improvement (OR 1.10), @entity1761 (OR 1.31), non-absorbable @entity7967 (OR 2.75), @entity5154 (OR 2.22). In addition, @entity35861 (MD -20.18, 95% CI -40.12 to -0.27) provided a significant reduction in blood @entity3265 concentration compared with observation. @entity5154 appeared to be associated with more adverse events in comparison with non-absorbable @entity7967 (OR 10.15), @entity1761 (OR 17.31), @entity35861 (OR 3.16) or BCAA (OR 7.69). CONCLUSIONS: @entity35861 treatment may show a trend in superiority for clinical efficacy among standard interventions for OHE. @entity1761 shows the greatest reduction in blood ammonia concentration, and treatment with @entity5154 demonstrates a higher probability in causing adverse effects among the five compared interventions.
