Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 7;10(18):4050.
doi: 10.3390/jcm10184050.

New Therapies of Liver Diseases: Hepatic Encephalopathy

Chiara Mangini  1 , Sara Montagnese  1
Affiliations
Review

New Therapies of Liver Diseases: Hepatic Encephalopathy

Chiara Mangini et al. J Clin Med. .

Abstract

Hepatic encephalopathy (HE) is a common complication of advanced liver disease which has profound implications in terms of the patients' ability to fulfil their family and social roles, to drive and to provide for themselves. Recurrent and persistent HE is still a serious management challenge, translating into a significant burden for patients and their families, health services and society at large. The past few years have been characterized by significantly more attention towards HE and its implications; its definition has been refined and a small number of new drugs/alternative management strategies have become available, while others are underway. In this narrative review we summarize them in a pragmatic and hopefully useful fashion.

Keywords: ammonia; cirrhosis; portal-systemic shunt; vigilance.

PubMed Disclaimer

Conflict of interest statement

S.M.’s group has received research funding from AlfaSigma S.p.a., Norgine Ltd., Merz Pharmaceuticals GmbH, Umecrine Cognition AB and Versantis AG.

References

    1. Vilstrup H., Amodio P., Bajaj J., Cordoba J., Ferenci P., Mullen K.D., Weissenborn K., Wong P. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60:715–735. doi: 10.1002/hep.27210. - DOI - PubMed
    1. Strauss E., Tramote R., Silva E.P., Caly W.R., Honain N.Z., Maffei R.A. Doubleblind randomized clinical trial comparing neomycin and placebo in the treatment of exogenous hepatic encephalopathy. Hepatogastroenterology. 1992;39:542–545. - PubMed
    1. Mullen K.D., Sanyal A.J., Bass N.M., Poordad F.F., Sheikh M.Y., Frederick R.T., Bortey E., Forbes W.P. Rifaximin is safe and well tolerated for long-term maintenance of remission from overt hepatic encephalopathy. Clin. Gastroenterol. Hepatol. 2014;12:1390–1397.e2. doi: 10.1016/j.cgh.2013.12.021. - DOI - PubMed
    1. Bajaj J.S., Barrett A.C., Bortey E., Paterson C., Forbes W.P. Prolonged remission from hepatic encephalopathy with rifaximin: Results of a placebo crossover analysis. Aliment. Pharmacol. Ther. 2015;41:39–45. doi: 10.1111/apt.12993. - DOI - PMC - PubMed
    1. Sharma P., Agrawal A., Sharma B.C., Sarin S.K. Prophylaxis of hepatic encephalopathy in acute variceal bleed: A randomized controlled trial of lactulose versus no lactulose. J. Gastroenterol. Hepatol. 2011;26:996–1003. doi: 10.1111/j.1440-1746.2010.06596.x. - DOI - PubMed

LinkOut - more resources