SynthesisPloS one2022
Combination therapy with rifaximin and lactulose in hepatic encephalopathy: A systematic review and meta-analysis.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- [Chinese guidelines for clinical diagnosis, treatment, and management of cirrhosis (2025)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Guideline
- Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential application dosages and strategies: a network meta-analysis.BMC gastroenterology · 2024Pooled it
- Probiotics are beneficial for liver cirrhosis: a systematic review and meta-analysis of randomized control trials.Frontiers in medicine · 2024Pooled it
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- The role of systemic inflammation in hepatic encephalopathy: advances in inflammatory mechanisms, prevention and treatment research.Annals of medicine · 2026Review
- Review
- Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management.Clinical journal of gastroenterology · 2026Review
- Microbiome alternative treatments for hepatic encephalopathy: Reassessment of the potential use of lactose in lactase non-persistent cirrhosis patients.Canadian liver journal · 2026Article
- Article
- [Hepatic encephalopathy from cholangitis in a young patient with ornithine transcarbamylase mutation].Revista medica del Instituto Mexicano del Seguro Social · 2026Article
- Understanding Hepatic Encephalopathy: Patient Knowledge, Adherence, and Barriers to Care in Cirrhosis.Cureus · 2026Article
- Chinese Guidelines for Clinical Diagnosis, Treatment, and Management of Cirrhosis (2025).Journal of clinical and translational hepatology · 2026Article
- Lactulose, Rifaximin, and Survival in Hepatic Encephalopathy: A Cohort Study of 120 Patients.Journal of clinical medicine · 2025Article
- Incidence and efficacy of strategies for preventing hepatic encephalopathy following transjugular intrahepatic portosystemic shunt: A meta-analysis.World journal of hepatology · 2025Article
- Chinese Guidelines on the Management of Hepatic Encephalopathy in Cirrhosis (2024).Journal of clinical and translational hepatology · 2025Article
- Real-world experience with direct-acting antiviral therapy in HCV-infected patients with cirrhosis and esophageal varices.Pharmacological reports : PR · 2024Article
- [Chinese guidelines on the management of hepatic encephalopathy in cirrhosis (2024)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- A Prospective Multimodal Education Intervention for Providers Does Not Increase Hepatic Encephalopathy Treatment Rates.Digestive diseases and sciences · 2024Article
- Impact of rifaximin use in infections and mortality in patients with decompensated cirrhosis and hepatic encephalopathy.Therapeutic advances in gastroenterology · 2024Article
- Rifaximin Use, Adherence and Persistence in Patients with Hepatic Encephalopathy: A Real-World Study in the South of Italy.Journal of clinical medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Rifaximin and lactulose are widely used in patients with hepatic encephalopathy (HE); however, data on whether the combined use of rifaximin and lactulose could yield additional benefits for patients with HE are limited and inconclusive. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the treatment effectiveness of rifaximin plus lactulose versus lactulose alone in patients with HE. Electronic databases (PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure) were searched for eligible RCTs from their inception until November 2020. Relative risks (RRs) with 95% confidence intervals (CIs) were applied to calculate pooled effect estimates for the treatment effectiveness of rifaximin plus lactulose versus lactulose alone by using the random-effects model. Sensitivity, subgroup, and publication bias analyses were also performed. We included 7 RCTs enrolling 843 patients with HE. We noted that the use of rifaximin plus lactulose was associated with an increased incidence of effective rate than lactulose alone (RR, 1.30; 95% CI, 1.10-1.53; P = 0.002). Moreover, the use of rifaximin plus lactulose was associated with a reduced risk of mortality as compared with lactulose alone (RR, 0.57; 95% CI, 0.41-0.80; P = 0.001). This study found that the use of rifaximin in combination with lactulose could provide additional benefits in terms of increased effective rate and decreased mortality than lactulose alone in patients with HE.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.